Mortality among Care Home Residents in England during the first and second waves of the COVID-19 pandemic: an observational study of 4.3 million adults over the age of 65.
Mortality among Care Home Residents in England during the first and second waves of the COVID-19 pandemic: an observational study of 4.3 million adults over the age of 65.
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DOI：
10.1016/j.lanepe.2021.100295
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发表时间：
2022-03
期刊：
影响因子：
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通讯作者：
Leon DA
中科院分区：
文献类型：
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作者：
Schultze A;Nightingale E;Evans D;Hulme W;Rosello A;Bates C;Cockburn J;MacKenna B;Curtis HJ;Morton CE;Croker R;Bacon S;McDonald HI;Rentsch CT;Bhaskaran K;Mathur R;Tomlinson LA;Williamson EJ;Forbes H;Tazare J;Grint D;Walker AJ;Inglesby P;DeVito NJ;Mehrkar A;Hickman G;Davy S;Ward T;Fisher L;Green AC;Wing K;Wong AY;McManus R;Parry J;Hester F;Harper S;Evans SJ;Douglas IJ;Smeeth L;Eggo RM;Goldacre B;Leon DA
护理院的居民受到COVID-19的严重影响。我们描述了与私人住宅相比，养老院居民死亡风险的趋势。我们代表英国NHS使用OpenSAFELY-TPP计算2019年1月2日至2021年3月31日期间年龄≥ 65岁的成年人因所有原因和COVID-19导致的每月年龄标准化死亡风险。护理之家的居民被确定使用链接到护理和质量委员会的数据。截至2019年2月1日，我们纳入了4，340，648名年龄在65岁或以上的人，其中2.2%被归类为居住在护理或养老院。2019年2月，护理院居民的标准化死亡风险约为私人住房居民的10倍：女性的比较死亡率数字（CMF）= 10.59（95%CI = 9.51，11.81），男性为10.87（9.93，11.90）。到2020年4月，这些相对差异增加到17倍以上，女性CMF为17.57（16.43，18.79），男性为18.17（17.22，19.17）。尽管年龄标准化的COVID-19死亡风险绝对值上升，但CMF在第二波期间并未增加。与私人住宅的老年居民相比，COVID-19对英格兰养老院居民的死亡率产生了不成比例的影响，但仅在第一波。这可能是由于某种程度的后天免疫力、保护措施的改进或人口基本脆弱性的改变。护理院人口应优先采取旨在控制COVID-19的措施。医学研究理事会MR/V015737/1
Residents in care homes have been severely impacted by COVID-19. We describe trends in the mortality risk among residents of care homes compared to private homes. On behalf of NHS England we used OpenSAFELY-TPP to calculate monthly age-standardised risks of death due to all causes and COVID-19 among adults aged >=65 years between 1/2/2019 and 31/03/2021. Care home residents were identified using linkage to Care and Quality Commission data. We included 4,340,648 people aged 65 years or older on the 1st of February 2019, 2.2% of whom were classified as residing in a care or nursing home. Age-standardised mortality risks were approximately 10 times higher among care home residents compared to those in private housing in February 2019: comparative mortality figure (CMF) = 10.59 (95%CI = 9.51, 11.81) among women, and 10.87 (9.93, 11.90) among men. By April 2020 these relative differences had increased to more than 17 times with CMFs of 17.57 (16.43, 18.79) among women and 18.17 (17.22, 19.17) among men. CMFs did not increase during the second wave, despite a rise in the absolute age-standardised COVID-19 mortality risks. COVID-19 has had a disproportionate impact on the mortality of care home residents in England compared to older residents of private homes, but only in the first wave. This may be explained by a degree of acquired immunity, improved protective measures or changes in the underlying frailty of the populations. The care home population should be prioritised for measures aimed at controlling COVID-19. Medical Research Council MR/V015737/1