在过去六个月生命中，居家度日的社区居住老年人。
Days Spent at Home in the Last Six Months of Life Among Community-Living Older Persons.
机构信息
Department of Internal Medicine, Yale School of Medicine, New Haven, Conn.
Department of Internal Medicine, Yale School of Medicine, New Haven, Conn.
出版信息
Am J Med. 2019 Feb;132(2):234-239. doi: 10.1016/j.amjmed.2018.10.029. Epub 2018 Nov 14.
BACKGROUND
Days spent at home has recently been identified as an important patient-centered outcome; yet, relatively little is known about time spent at home at the end of life among community-living older persons.
METHODS
The analytic sample included 457 decedents from an ongoing cohort study of 754 community-living persons, aged ≥70 years. Days spent at home were calculated as 180 days minus the number of days in a hospital, nursing home, or hospice facility. The condition leading to death was determined from death certificates and comprehensive assessments.
RESULTS
The median number of days at home was 159 (interquartile range 125-174). There were 138 (30.2%) decedents at home during the entire 6-month period, while 163 (35.7%) were at home for fewer than 150 days. Days at home did not differ significantly by age (P = .922), sex (P = .238), or race/ethnicity (P = .199), but did differ according to the condition leading to death (P = .001), with the lowest value observed for organ failure (150 [106.5-168.5]), highest values for sudden death (177 [172-179]) and cancer (167 [140-174]), and intermediate values for advanced dementia (164 [118-174]), frailty (160.5 [130-174]), and other conditions (153 [118-175]).
CONCLUSIONS
Among community-living older persons, days spent at home in the last 6 months of life do not differ by age, sex, or race/ethnicity, but are significantly lower for persons dying from organ failure. Additional efforts may be warranted to optimize time spent at home at the end of life, especially among older persons dying from organ failure.
背景
最近，在家天数被认为是一个重要的以患者为中心的结局指标；然而，对于社区居住的老年人在生命末期的在家时间，我们知之甚少。
方法
分析样本包括来自一个正在进行的 754 名社区居住者队列研究的 457 名死者，年龄≥70 岁。在家天数的计算方法是 180 天减去住院、疗养院或临终关怀机构的天数。导致死亡的疾病是根据死亡证明和综合评估确定的。
结果
在家的中位数天数为 159（四分位距 125-174）。在整个 6 个月期间，有 138 名（30.2%）死者在家，而有 163 名（35.7%）死者在家时间少于 150 天。在家天数与年龄（P=0.922）、性别（P=0.238）或种族/民族（P=0.199）无显著差异，但与导致死亡的疾病有关（P=0.001），器官衰竭的最低值为 150（106.5-168.5），猝死最高值为 177（172-179），癌症最高值为 167（140-174），晚期痴呆症为 164（118-174），虚弱症为 160.5（130-174），其他疾病为 153（118-175）。
结论
在社区居住的老年人中，生命最后 6 个月在家的天数不因年龄、性别或种族/民族而异，但死于器官衰竭的人明显较低。可能需要进一步努力，优化生命末期在家的时间，特别是在死于器官衰竭的老年人中。
Zotero 插件