Faculty of Health, University of Canberra, Canberra, Australian Capital Territory, Australia.
BMJ Open. 2013 Jun 20;3(6):e002770. doi: 10.1136/bmjopen-2013-002770.
To identify rates of potentially preventable complications for dementia patients compared with non-dementia patients.
Retrospective cohort design using hospital discharge data for dementia patients, case matched on sex, age, comorbidity and surgical status on a 1 : 4 ratio to non-dementia patients.
Public hospital discharge data from the state of New South Wales, Australia for 2006/2007.
426 276 overnight hospital episodes for patients aged 50 and above (census sample).
Rates of preventable complications, with episode-level risk adjustment for 12 complications that are known to be sensitive to nursing care.
Controlling for age and comorbidities, surgical dementia patients had higher rates than non-dementia patients in seven of the 12 complications: urinary tract infections, pressure ulcers, delirium, pneumonia, physiological and metabolic derangement (all at p<0.0001), sepsis and failure to rescue (at p<0.05). Medical dementia patients also had higher rates of these complications than did non-dementia patients. The highest rates and highest relative risk for dementia patients compared with non-dementia patients, in both medical and surgical populations, were found in four common complications: urinary tract infections, pressure areas, pneumonia and delirium.
Compared with non-dementia patients, hospitalised dementia patients have higher rates of potentially preventable complications that might be responsive to nursing interventions.
比较痴呆症患者与非痴呆症患者潜在可预防并发症的发生率。
利用痴呆症患者的医院出院数据进行回顾性队列设计，按性别、年龄、合并症和手术状态进行病例匹配，匹配比例为 1:4 与非痴呆症患者进行匹配。
澳大利亚新南威尔士州公立医院出院数据，时间为 2006/2007 年。
50 岁及以上患者的 426 276 个过夜住院病例（普查样本）。
12 种已知对护理敏感的可预防并发症的发生率，通过对 12 种并发症的病例水平风险调整。
在控制年龄和合并症的情况下，与非痴呆症患者相比，手术性痴呆症患者在 12 种并发症中的 7 种并发症中的发生率更高：尿路感染、压疮、谵妄、肺炎、生理和代谢紊乱（均 p<0.0001）、败血症和未能抢救（p<0.05）。与非痴呆症患者相比，医疗性痴呆症患者也有更高的这些并发症发生率。在医疗和手术人群中，痴呆症患者与非痴呆症患者相比，四种常见并发症（尿路感染、压疮、肺炎和谵妄）的发生率和相对风险最高。
与非痴呆症患者相比，住院痴呆症患者有更高的潜在可预防并发症发生率，这些并发症可能对护理干预有反应。
