Howarth S, Clarke C, Bayliss R, Whitfield A G, Semmence J, Healy M J
Research Unit, Royal College of Physicians, London.
BMJ. 1990 Mar 31;300(6728):844-7. doi: 10.1136/bmj.300.6728.844.
To determine whether admitting elderly patients to hospital to give temporary relief to their carers is associated with increased mortality.
Prospective multicentre study comparing the mortality of patients admitted on a one off or rotational basis with that experienced while they were awaiting admission.
A wide range of urban and rural district general, geriatric or long stay, and general practitioner hospitals.
474 Patients aged 70 or over who had 601 admissions.
Death.
16 (3.4%) Of the 474 patients (2.7% of all 601 admissions) died while in hospital during an average stay of 15.7 days whereas 23 (4.9%) patients died while awaiting admission (average waiting time was 34.2 days). The 16 deaths in hospital and the 23 deaths during the longer waiting period correspond to death rates of 19.9 and 12.5 per 10,000 person days respectively. The difference between these of 7.4 is not statistically significant (95% confidence interval -3.6 to 18.3). The estimated relative risk of dying in hospital is 1.59 but the 95% confidence interval is wide (0.84 to 3.01).
Although the death rates are slightly higher in those admitted to hospital for relief care than in those awaiting admission, the difference was not significant, and the death rate in both groups was reassuringly small.
确定让老年患者住院以临时减轻其护理人员负担是否会增加死亡率。
前瞻性多中心研究,比较一次性或轮流住院患者的死亡率与等待住院期间的死亡率。
广泛的城乡地区综合医院、老年病医院或长期住院医院以及全科医生医院。
474名70岁及以上的患者,共住院601次。
死亡。
474名患者中有16名(3.4%)(占所有601次住院的2.7%)在平均住院15.7天期间死亡,而23名(4.9%)患者在等待住院期间死亡(平均等待时间为34.2天)。住院期间的16例死亡和较长等待期内的23例死亡分别对应每10000人日19.9和12.5的死亡率。两者之间7.4的差异无统计学意义(95%置信区间为-3.6至18.3)。住院死亡的估计相对风险为1.59,但95%置信区间较宽(0.84至3.01)。
尽管接受缓解护理住院患者的死亡率略高于等待住院患者,但差异不显著,且两组死亡率均低得令人安心。