Kitamura Tatsuru, Kitamura Maki, Hino Shoryoku, Kurata Koichi
Department of Neuropsychiatry, Ishikawa Prefectural Takamatsu Hospital, Kahoku City, Japan.
Dement Geriatr Cogn Dis Extra. 2013 Mar 23;3(1):86-95. doi: 10.1159/000350028. Print 2013 Jan.
BACKGROUND/AIMS: In Japan, more than 50,000 patients with dementia are housed in psychiatric facilities, a trend precipitated by prolonged hospitalizations. This study aimed to determine predictors for the time to discharge in patients hospitalized for behavioral and psychological symptoms of dementia (BPSD).
Medical charts of patients admitted to an acute psychogeriatric ward for treatment of BPSD were reviewed. Cox's proportional hazards model was used to evaluate relationships between active behavioral problems and/or demographics at the time of admission, and the time until favorable discharge (FD), defined as discharge to the patient's own home or a care facility.
For the 402 study patients included in this study, median time to FD was 101 days. In addition to family and residential factors, multivariate analysis identified higher Mini-Mental State Examination scores as independent clinical predictors for a shorter hospital stay, whereas male gender and combative behavior as the primary reason for hospital admission were predictors for a longer hospital stay.
Clinical characteristics can be predictive of the time to discharge for patients with BPSD. Earlier interventions and enhanced care strategies may be needed for patients with a lower likelihood of FD.
背景/目的:在日本,超过5万名痴呆症患者被安置在精神科设施中,这一趋势是由长期住院引发的。本研究旨在确定因痴呆症行为和心理症状(BPSD)住院患者的出院时间预测因素。
回顾了因BPSD入住急性老年精神科病房接受治疗的患者的病历。采用Cox比例风险模型评估入院时的积极行为问题和/或人口统计学特征与直至良好出院(FD)的时间之间的关系,良好出院定义为出院至患者自己家中或护理机构。
本研究纳入的402例患者中,FD的中位时间为101天。除家庭和居住因素外,多变量分析确定,较高的简易精神状态检查表得分是住院时间较短的独立临床预测因素,而男性以及因攻击性为主要入院原因是住院时间较长的预测因素。
临床特征可预测BPSD患者的出院时间。对于FD可能性较低的患者,可能需要更早的干预措施和强化护理策略。