Park Hye-Sang, Lee Kyu-Tae, Kim Tae-Woon
Department of Physiology, College of Medicine, Kyung Hee University, Seoul, Korea.
Lohas Eun-Pyung Hyo-Hospital, Seoul, Korea.
J Exerc Rehabil. 2017 Apr 30;13(2):250-254. doi: 10.12965/jer.1734950.475. eCollection 2017 Apr.
The prediction of life-expectancy in terminally ill patients is important both for medical and social reasons but it is widely recognized as being inaccurate. The aim of this study was to investigate the mortality predictors and indicators of life extension among elderly patients in a hospice service center. In order to determine the mortality predictors, we investigated the relationship between patients' cognitive status using the Korean-Mini Mental State Examination & Global Deterioration Scale (K-MMSE & GDS), the patient's physical function using the instrumental Activities of Daily Living (ADL) score, and the patient's blood component values. The subjects included 43 men and 57 women with a mean age of 82.4±8.4 years, and a mean nursing period of 11.1±12.2 months. These terminally ill patients were enrolled in a cross-sectional study. All data were collected from paper and electronic charts, and patient interviews. A simple correlation analysis was performed to determine the relationship between the variables and to satisfy the normal distribution (<0.01). The results revealed that the time of death negatively correlated with ADL score (=-0.273, =0.006). However, the K-MMSE & GDS, and the values of blood component such as albumin, gamma-glutamic transpeptidase, blood urea nitrogen, and creatinine were not correlated with the time of death. Consequently, the ADL score might be an important predictor of mortality and life extension in elderly patients. Therefore, in order to improve ADL score, physical exercise and overall fitness may be potential non-pharmacologic methods useful in preventing mortality in elderly people.
对晚期患者的预期寿命进行预测，无论从医学还是社会角度来看都很重要，但人们普遍认为这种预测并不准确。本研究的目的是调查临终关怀服务中心老年患者的死亡预测因素和寿命延长指标。为了确定死亡预测因素，我们调查了使用韩国简易精神状态检查表和总体衰退量表（K-MMSE&GDS）评估的患者认知状态、使用日常生活活动能力（ADL）评分评估的患者身体功能以及患者的血液成分值之间的关系。研究对象包括43名男性和57名女性，平均年龄为82.4±8.4岁，平均护理期为11.1±12.2个月。这些晚期患者参与了一项横断面研究。所有数据均从纸质和电子病历以及患者访谈中收集。进行了简单相关分析以确定变量之间的关系并满足正态分布（<0.01）。结果显示，死亡时间与ADL评分呈负相关（=-0.273，=0.006）。然而，K-MMSE&GDS以及血液成分值，如白蛋白、γ-谷氨酰转肽酶、血尿素氮和肌酐，与死亡时间无关。因此，ADL评分可能是老年患者死亡和寿命延长的重要预测指标。所以，为了提高ADL评分，体育锻炼和整体健康状况可能是预防老年人死亡的潜在非药物方法。
