Carl von Ossietzky University Oldenburg, Department of Health Services Research, Oldenburg, Germany.
Carl von Ossietzky University Oldenburg, Department of Health Services Research, Oldenburg, Germany.
Arch Gerontol Geriatr. 2019 May-Jun;82:293-298. doi: 10.1016/j.archger.2019.03.013. Epub 2019 Mar 19.
Nursing home residents (NHR) often suffer from dementia. As end-of-life care of NHR with dementia and without might differ, our aim was to investigate patterns of in-hospital deaths in NHR with and without dementia.
Retrospective observational study.
German nursing homes.
Deceased NHR.
Using data of a large German health insurance fund, we included NHR aged 65+ years who died between January 1, 2010, and December 31, 2014. We assessed proportions of in-hospital deaths stratified by dementia status as well as by age, sex, level of care and length of stay. Multiple logistic regression models were applied to explore the association of these variables with in-hospital death.
Data on 67,328 decedents were included (mean age 85.3 years, 69.8% female), of whom 43.1% suffered from dementia. Overall, 29.5% died in hospital, with similar figures found for those with dementia (29.2%) and those without (29.8%). Differences between NHR with and without dementia were noticeable regarding age and length of stay. In those with dementia, the proportion of in-hospital deaths decreased linearly with age from 37.0%-20.2% (65-74 to 95+ years). These results are supported by the multivariate analyses. The terminal hospital stay was up to 3 days in 32.6%. This length did not differ by dementia status.
Germany has a high proportion of NHR in-hospital deaths. Surprisingly, we found no differences in these figures between NHR with and without dementia, although predictors for in-hospital death seem to differ between these groups.
养老院居民（NHR）经常患有痴呆症。由于患有痴呆症和没有痴呆症的 NHR 的临终护理可能不同，我们的目的是调查患有和不患有痴呆症的 NHR 的院内死亡模式。
回顾性观察性研究。
德国养老院。
已故的 NHR。
我们使用一家大型德国健康保险公司的数据，纳入了 2010 年 1 月 1 日至 2014 年 12 月 31 日期间死亡的年龄在 65 岁以上的 NHR。我们评估了按痴呆症状况以及按年龄、性别、护理水平和住院时间分层的院内死亡比例。应用多变量逻辑回归模型探讨这些变量与院内死亡的关系。
共纳入 67328 名死者（平均年龄 85.3 岁，69.8%为女性），其中 43.1%患有痴呆症。总体而言，29.5%的人在医院死亡，患有痴呆症的人和没有痴呆症的人比例相似（分别为 29.2%和 29.8%）。痴呆症患者和非痴呆症患者在年龄和住院时间方面存在差异。在患有痴呆症的患者中，院内死亡比例随年龄呈线性下降，从 37.0%降至 20.2%（65-74 岁至 95 岁以上）。这些结果得到了多变量分析的支持。最后住院时间长达 3 天的比例为 32.6%。这一长度与痴呆症状况无关。
德国有很高比例的 NHR 院内死亡。令人惊讶的是，我们发现患有痴呆症和没有痴呆症的 NHR 在这些数字上没有差异，尽管这些组之间的院内死亡预测因素似乎不同。
