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患者报告的改善与康复特征与死亡率的关联。

The association of patient-reported improvement and rehabilitation characteristics with mortality.

机构信息

Department of Psychiatry, University of Rochester Medical Center (URMC), 300 Crittenden Blvd, Rochester, NY 14642, USA.

Division of Geriatrics, Department of Medicine, URMC, 435 East Henrietta Road, Rochester, NY 14620, USA.

出版信息

Geriatr Nurs. 2019 Nov-Dec;40(6):620-628. doi: 10.1016/j.gerinurse.2019.06.006. Epub 2019 Jul 9.

Abstract

This study aims to investigate the association of patient-reported improvement and rehabilitation characteristics with mortality among older adults who received rehabilitation. To do so, a national sample of Medicare beneficiaries from the National Health and Aging Trends Study was examined. Among those who reported receiving rehabilitation services in the 2015 interview (N = 1,188), 4.2% were deceased at the 2016 follow-up interview. Mortality was more common among those who had received rehabilitation in nursing home or inpatient and in-home settings compared to outpatient rehabilitation settings. In multivariable analyses accounting for demographics and health status, patient-reported worsening of functioning during rehabilitation (OR=15.69; 95% CI: 1.84-133.45) and cardiovascular disease (OR=4.15; 95% CI: 1.41-12.17) were associated with mortality. Among older adults who received rehabilitation, 1 in 25 were deceased at follow-up. That patient-reported functioning is associated with mortality suggests that more systematically including patient-reported outcomes in rehabilitation care may be clinically pertinent.

摘要

本研究旨在探讨患者报告的康复改善情况和康复特征与接受康复治疗的老年人死亡率之间的关系。为此,对国家健康老龄化趋势研究中的国家医疗保险受益人的全国样本进行了检查。在那些报告在 2015 年访谈中接受康复服务的人中(n=1188),4.2%在 2016 年随访访谈时已经死亡。与门诊康复环境相比,在养老院或住院和家庭环境中接受康复治疗的患者死亡率更高。在多变量分析中,考虑到人口统计学和健康状况,患者报告在康复过程中功能恶化(OR=15.69;95%CI:1.84-133.45)和心血管疾病(OR=4.15;95%CI:1.41-12.17)与死亡率相关。在接受康复治疗的老年人中,每 25 人中就有 1 人在随访时死亡。患者报告的功能与死亡率相关,这表明在康复护理中更系统地纳入患者报告的结果可能具有临床相关性。

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本文引用的文献

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Patient-Reported Outcomes in Functioning Following Nursing Home or Inpatient Rehabilitation.
J Am Med Dir Assoc. 2018 Oct;19(10):864-870. doi: 10.1016/j.jamda.2018.06.014. Epub 2018 Jul 25.
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Can Older Adults Accurately Report Their Use of Physical Rehabilitation Services?
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