痴呆症和心血管疾病病史患者的死亡率和住院再入院风险增加：一项全国性登记研究的结果。
Increased mortality and hospital readmission risk in patients with dementia and a history of cardiovascular disease: Results from a nationwide registry linkage study.
机构信息
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
Department of Geriatrics, University Medical Center Utrecht, Utrecht, The Netherlands.
出版信息
Int J Geriatr Psychiatry. 2019 Mar;34(3):488-496. doi: 10.1002/gps.5044. Epub 2018 Dec 21.
OBJECTIVE
To evaluate the impact of cardiovascular disease (CVD) on mortality and readmission risk in patients with dementia.
METHODS
Prospective hospital-based cohort of 59 194 patients with dementia admitted to hospital or visiting a day-clinic between 2000 and 2010. Patients were divided in those with and without a history of CVD (ie, previous admission for CVD; coronary heart disease, heart failure, stroke, atrial fibrillation, or other CVD). Absolute mortality risks (ARs), median survival times, and hazard ratios (adjusted for age, sex, and comorbidity) were calculated.
RESULTS
Three-year ARs and HRs were higher, and survival times were shorter among patients visiting a day-clinic with a history of CVD than in those without. The differences were less pronounced for inpatients. Readmission risk was further increased in the presence of CVD in both day clinic and inpatients.
CONCLUSION
Clinicians need to be more aware of worse prognosis of the population with CVD and dementia.
目的
评估心血管疾病（CVD）对痴呆患者死亡率和再入院风险的影响。
方法
这是一项前瞻性的基于医院的队列研究，纳入了 59194 名 2000 年至 2010 年间因痴呆住院或日间门诊就诊的患者。患者分为有和无 CVD 病史（即，先前因 CVD 入院；冠心病、心力衰竭、中风、心房颤动或其他 CVD）两组。计算了绝对死亡率（AR）、中位生存时间和风险比（调整年龄、性别和合并症）。
结果
与无 CVD 病史的患者相比，有 CVD 病史的日间门诊就诊患者的 3 年 AR 和 HR 更高，生存时间更短。住院患者的差异则不那么明显。日间门诊和住院患者中存在 CVD 时，再入院风险进一步增加。
结论
临床医生需要更加意识到 CVD 和痴呆患者的预后更差。
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