Connolly Martin J, Broad Joanna B, Boyd Michal, Kerse Ngaire, Gott Merryn
Freemasons' Department of Geriatric Medicine, University of Auckland, Auckland, New Zealand.
Australas J Ageing. 2014 Jun;33(2):114-20. doi: 10.1111/ajag.12010. Epub 2013 Mar 11.
To describe short-term mortality among residential aged care (RAC) residents in Auckland, New Zealand.
Prospective follow-up, 6828 residents (median age 86 years, 69.8% women) from census-type survey (10/9/2008); 152 facilities. Mortality data from central sources.
Eight hundred and sixty-one (12.6%) died by 6 months. Survival related to RAC length of stay before the survey: those resident <1 month (subgroup, n = 380) having 80.0% survival, 1-6 months 83.2% and >6 months 87.4% (P < 0.0001). In those admitted to private hospital from acute hospital (n = 104 of the subgroup of 380), 6-month mortality was 36.5% (P < 0.0001 vs other 'short stayers'). Significant mortality predictors were: private hospital admission from acute hospital (hazard ratio (HR) = 2.02), unscheduled GP visit during the prior 2 weeks (HR = 1.90), personal care disability (HR = 1.90) and acute hospital admission number during the previous 2 years (≥3; HR = 5.40).
RAC mortality (especially post admission) is high. Training and resource in the sector should reflect this.
描述新西兰奥克兰地区老年护理机构（RAC）居民的短期死亡率。
前瞻性随访，对2008年9月10日人口普查式调查中的6828名居民（中位年龄86岁，女性占69.8%）进行研究；涉及152家机构。死亡率数据来自中央数据源。
6个月内有861人（12.6%）死亡。生存率与调查前在RAC的住院时长有关：住院时间<1个月的居民（亚组，n = 380）生存率为80.0%，1 - 6个月为83.2%，>6个月为87.4%（P < 0.0001）。在从急症医院转入私立医院的患者中（380人亚组中的104人），6个月死亡率为36.5%（与其他“短期住院者”相比，P < 0.0001）。显著的死亡预测因素为：从急症医院转入私立医院（风险比（HR）= 2.02）、前两周内有计划外全科医生就诊（HR = 1.90）、个人护理失能（HR = 1.90）以及前两年内急症医院住院次数（≥3次；HR = 5.40）。
RAC的死亡率（尤其是入院后）很高。该领域的培训和资源应反映这一点。
