Differences in end-of-life preferences between congestive heart failure and dementia in a medical house calls program
Differences in end-of-life preferences between congestive heart failure and dementia in a medical house calls program
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DOI：
10.1111/j.1532-5415.2004.52210.x
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发表时间：
2004-05-01
影响因子：
6.3
通讯作者：
Finucane, T
中科院分区：
文献类型：
--
作者：
Haydar, ZR;Lowe, AJ;Finucane, T
目的：比较患有痴呆症和充血性心力衰竭 (CHF) 的老年人的临终偏好。设计：回顾性病例对照研究。背景：老年病学家主导的使用电子病历的跨学科上门计划。参与者：1996 年 10 月至 2001 年 4 月期间在上门计划护理下死亡的居家个人。测量：医疗记录审查，包括人口统计、功能状态、结果：在该计划中死亡的 172 名患者中，29 人患有慢性心力衰竭，79 人患有痴呆症，34 人同时患有这两种疾病，30 人两者都没有。 CHF 患者较年轻（82.6 vs 87.0，P=.011）且功能依赖性较低（日常生活活动评分 9.1 vs 11.5，P=.001）。从入组到死亡的时间没有显着差异（CHF 的平均+/-标准差=444+/-375 天，痴呆症的平均+/-标准差=325+/-330 天，P=.113）。 62% 的 CHF 患者和 91% 的痴呆患者接受了不复苏 (DNR) 指令（P
OBJECTIVES: To compare end-of-life preferences in elderly individuals with dementia and congestive heart failure (CHF).DESIGN: Retrospective case-control study.SETTING: Geriatrician-led interdisciplinary house-call program using an electronic medical record.PARTICIPANTS: Homebound individuals who died while under the care of the house-call program from October 1996 to April 2001.MEASUREMENTS: Medical records review for demographics, functional status, advance medical planning, hospice use, and place of death.RESULTS: Of 172 patients who died in the program, 29 had CHF, 79 had dementia, 34 had both, and 30 had neither. Patients with CHF were younger (82.6 vs 87.0, P=.011) and less functionally dependent (activities of daily living score 9.1 vs 11.5, P=.001). Time from enrollment to death was not significantly different (mean+/-standard deviation=444+/-375 days for CHF vs 325+/-330 days for dementia, P=.113). A do-not-resuscitate (DNR) directive was given in 62% of patients with CHF and 91% with dementia (P