Natalwala Ammar, Potluri Rahul, Uppal Hardeep, Heun Reinhard
The Medical School, University of Birmingham, Birmingham, UK.
Dement Geriatr Cogn Disord. 2008;26(6):499-505. doi: 10.1159/000171044. Epub 2008 Nov 13.
There is a lack of evidence to explain why patients with dementia are admitted to a general hospital.
Main reasons for hospitalisation were investigated in all patients admitted to a multi-ethnic general hospital during 2002-2007, by analysis of type of admission and primary diagnosis on admission. Anonymised data from the Hospital Activity Analysis Register was used to trace these patients; 505 were diagnosed with Alzheimer's disease (AD), 283 with vascular dementia (VD) and 1,773 patients were classified as unspecified dementia (UnD). Logistic regression analysis was used to compare these groups to 53,123 age-matched controls. Statistical significance of p < 0.001 was accepted.
More dementia patients were admitted as emergency cases compared to controls (AD = 95.8%, VD = 95.4%, UnD = 96.7%, controls = 54.4%; p < 0.001 for all comparisons). The proportion of patients admitted for dementia as their primary diagnosis was small (AD = 5.9%, VD = 10.6%, UnD = 6.0%). Primary diagnoses such as syncope and collapse, bronchopneumonia, urinary tract infection and dehydration were more frequent in all dementia patients than controls.
Dementia patients are frequently admitted as emergency cases, but dementia itself is often not the primary diagnosis. Earlier detection of the specific conditions mentioned above may reduce emergency hospital admissions amongst dementia patients.
缺乏证据来解释为何痴呆症患者会被收治到综合医院。
通过分析入院类型和入院时的主要诊断,对2002年至2007年期间入住一家多民族综合医院的所有患者的住院主要原因进行了调查。利用医院活动分析登记册中的匿名数据追踪这些患者;505例被诊断为阿尔茨海默病(AD),283例为血管性痴呆(VD),1773例患者被归类为未明确的痴呆症(UnD)。采用逻辑回归分析将这些组与53123名年龄匹配的对照组进行比较。接受p < 0.001的统计学显著性。
与对照组相比,更多痴呆症患者作为急诊入院(AD = 95.8%,VD = 95.4%,UnD = 96.7%,对照组 = 54.4%;所有比较p < 0.001)。以痴呆症作为主要诊断入院的患者比例较小(AD = 5.9%,VD = 10.6%,UnD = 6.0%)。在所有痴呆症患者中,晕厥和虚脱、支气管肺炎、尿路感染和脱水等主要诊断比对照组更常见。
痴呆症患者经常作为急诊入院,但痴呆症本身往往不是主要诊断。早期发现上述特定情况可能会减少痴呆症患者的急诊住院人数。