老年心肺疾病和恶性肿瘤患者姑息治疗使用的国家趋势。
National trends in palliative care use among older adults with cardiopulmonary and malignant conditions.
机构信息
Yale University School of Nursing, P.O. Box 27399, West Haven, CT 06516, United States; VA Connecticut Healthcare System, West Haven, CT, United States.
Department of Surgery, Yale University School of Medicine, United States.
出版信息
Heart Lung. 2020 Jul-Aug;49(4):370-376. doi: 10.1016/j.hrtlng.2020.02.004. Epub 2020 Feb 27.
BACKGROUND
Palliative care consultation (PCC) is recommended for older adults hospitalized with cardiopulmonary conditions, but frequently is reserved for patients with malignant conditions and those with advanced age.
OBJECTIVES
To compare age-adjusted PCC trends and the relationship between increasing age and PCC among older adults with cardiopulmonary and malignant conditions.
METHODS
Observational analysis of patients age ≥ 65 years, stratified by age and cardiopulmonary (heart failure, chronic obstructive pulmonary disease) vs. malignant (lung and gastrointestinal) conditions. Age-adjusted PCC trends over time and compound annual growth rates (CAGR) were compared.
RESULTS
Discharges with cardiopulmonary vs. malignant conditions were older, more likely to be female, and white. Relative to malignant conditions, discharges with cardiopulmonary conditions had lower age-adjusted PCC rates but higher CAGRS. Increasing age was associated with PCC in both groups but had a stronger effect among cardiopulmonary conditions.
CONCLUSIONS
Older adults with cardiopulmonary conditions experienced lower rates of PCC, but higher rates of growth over time relative to those with malignant conditions.
背景
姑息治疗咨询（Palliative care consultation，PCC）被推荐用于因心肺疾病住院的老年患者，但通常仅保留给患有恶性疾病和高龄患者。
目的
比较心肺疾病和恶性疾病老年患者的年龄调整后 PCC 趋势，并分析年龄增加与 PCC 之间的关系。
方法
对年龄≥65 岁的患者进行观察性分析，按年龄和心肺疾病（心力衰竭、慢性阻塞性肺疾病）与恶性疾病（肺部和胃肠道）进行分层。比较随时间推移的年龄调整后 PCC 趋势和复合年增长率（compound annual growth rate，CAGR）。
结果
与恶性疾病相比，具有心肺疾病的出院患者年龄更大，更可能为女性，且为白人。与恶性疾病相比，具有心肺疾病的出院患者的年龄调整后 PCC 率较低，但 CAGR 较高。在两组患者中，年龄增加均与 PCC 相关，但在心肺疾病患者中相关性更强。
结论
与恶性疾病相比，具有心肺疾病的老年患者的 PCC 率较低，但随时间推移，其增长率较高。
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