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长期复杂持续护理环境中昏迷患者特征分析。

Profiling the Characteristics of People Who Are Comatose in Long-term and Complex Continuing Care Settings.

机构信息

GERAS Centre for Aging Research, McMaster University, Hamilton, Ontario, Canada; Department of Medicine, McMaster University, Hamilton, Ontario, Canada.

Saint Elizabeth Health Care, Toronto, Ontario, Canada; School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada.

出版信息

J Am Med Dir Assoc. 2019 Oct;20(10):1331-1334. doi: 10.1016/j.jamda.2019.04.026. Epub 2019 Jun 21.

Abstract

OBJECTIVES

To describe the sociodemographic, clinical, and treatment characteristics of people who are comatose in Canadian complex continuing care (CCC) and long-term care (LTC) settings, and to make recommendations to promote comprehensive care planning for this population.

DESIGN

Retrospective, cross-sectional analysis of population data.

SETTING AND PARTICIPANTS

All residents in the Canadian provinces of Alberta, Ontario, British Columbia, Manitoba, Nova Scotia, Newfoundland, Saskatchewan, and the territory of Yukon with data available from the fiscal year 2015 (April 1, 2015, to March 31, 2016).

MEASURES

Demographic, clinical, and treatment variables were extracted from the Resident Assessment Instrument-Minimum Data Set (MDS 2.0) and were reported using descriptive statistics.

RESULTS

Of the LTC and CCC populations, 0.07% and 3.5% were identified as comatose, respectively. Overall, people who are comatose in both CCC or LTC settings are younger and have a longer length of stay than those who are not comatose. A higher proportion of people who are comatose experience active infections and irregular bowel elimination patterns, and those who are comatose were more likely to have a feeding tube and require oxygen therapy or suctioning than those who were not comatose. However, a lower proportion of people who were comatose had documented pain. In LTC, one-quarter of people who are comatose are expected to die within 6 months.

CONCLUSION/IMPLICATIONS: Although the prevalence of people who are comatose in LTC and CCC settings is low, this population is complex and has significant care needs that require comprehensive assessment and care planning.

摘要

目的

描述加拿大复杂持续护理(CCC)和长期护理(LTC)环境中昏迷患者的社会人口学、临床和治疗特征,并提出建议,以促进该人群的全面护理计划。

设计

回顾性、横断面人群数据分析。

设置和参与者

2015 财政年度(2015 年 4 月 1 日至 2016 年 3 月 31 日)有数据的加拿大艾伯塔省、安大略省、不列颠哥伦比亚省、马尼托巴省、新斯科舍省、纽芬兰省、萨斯喀彻温省和育空地区的所有 LTC 和 CCC 居民。

测量方法

从居民评估工具-最低数据集中提取人口统计学、临床和治疗变量,并使用描述性统计进行报告。

结果

在 LTC 和 CCC 人群中,分别有 0.07%和 3.5%被确定为昏迷。总体而言,与非昏迷患者相比,处于 CCC 或 LTC 环境中的昏迷患者年龄更小,住院时间更长。更多昏迷患者经历活跃感染和不规则排便模式,与非昏迷患者相比,昏迷患者更有可能有喂养管、需要氧疗或吸痰。然而,昏迷患者的疼痛记录比例较低。在 LTC 中,四分之一的昏迷患者预计在 6 个月内死亡。

结论/意义:尽管 LTC 和 CCC 环境中昏迷患者的患病率较低,但该人群病情复杂,存在重大护理需求,需要全面评估和护理计划。

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