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居家医疗服务中死亡率的预测因素:来自沙特阿拉伯的数据。

Predictors of Mortality in Home Health Care Service: Data from Saudi Arabia.

作者信息

Alkeridy Walid A, Aljasser Arwa, Alayed Khalid Mohammed, Alsaad Saad M, Alqahtani Amani S, Lim Claire Ann, Alamri Sultan H, Mekkawy Doaa Zainhom, Al-Sofiani Mohammed

机构信息

Department of Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia.

Department of Medicine, Geriatric Division, University of British Columbia, Vancouver, Canada.

出版信息

J Multidiscip Healthc. 2022 Sep 7;15:1997-2005. doi: 10.2147/JMDH.S379782. eCollection 2022.

Abstract

OBJECTIVE

This study aimed to 1) report the prevalence of chronic conditions among Saudi people receiving long-term home health care (HHC) services, 2) identify the predictors of mortality among individuals receiving long-term HHC services, and 3) study the association between frailty and poor health outcomes among HHC users.

DESIGN

Retrospective cross-sectional descriptive study.

SETTING AND PARTICIPANTS

A total of 555 participants were recruited from HHC services at King Saud University Medical City (KSUMC), Riyadh, Saudi Arabia. We collected the data from electronic health records (EHR), patient charts, and caregiver interviews for 555 participants included in HHC program from the year 2019 to 2022.

METHODS

Only individuals fulfilling the HHC program's eligibility criteria were included to the study. A total of 555 participants were included in the analysis. We assessed the functional performance by the Katz activity of daily living and Bristol Activity of Daily Living Scale (BADLS). A trained health care provider assessed frailty using the Clinical Frailty Scale (CFS). We calculated the means and frequency to describe the prevalence of chronic conditions and variables of interest. A Chi-square test or independent-samples -test was run to determine if there were differences between the alive and deceased individuals. A binary logistic regression model was performed to predict mortality of HHC service recipients.

RESULTS

The mean age for deceased individuals in HHC was 78.3 years. Over twenty percent of individuals receiving HHC services were readmitted to the hospital. We found that the strongest predictors for mortality were pressure ulcers with an odds ratio of 3.75 and p-value of <0.0001, and the Clinical Frailty Scale, which had an odds ratio of 1.69 and p-value of 0.002, using multivariate regression analysis.

CONCLUSIONS AND IMPLICATIONS

In conclusion, our study found that pressure ulcers and frailty are the strongest predictors of mortality for individuals receiving home health care services.

摘要

目的

本研究旨在1)报告接受长期居家医疗保健(HHC)服务的沙特人群中慢性病的患病率,2)确定接受长期HHC服务的个体的死亡预测因素,以及3)研究HHC使用者中衰弱与健康不良结局之间的关联。

设计

回顾性横断面描述性研究。

设置与参与者

从沙特阿拉伯利雅得国王沙特大学医学城(KSUMC)的HHC服务中招募了555名参与者。我们从2019年至2022年纳入HHC项目的555名参与者的电子健康记录(EHR)、患者病历和护理人员访谈中收集数据。

方法

仅将符合HHC项目资格标准的个体纳入研究。共有555名参与者纳入分析。我们通过Katz日常生活活动能力量表和布里斯托尔日常生活活动量表(BADLS)评估功能表现。一名经过培训的医疗保健提供者使用临床衰弱量表(CFS)评估衰弱情况。我们计算均值和频率以描述慢性病的患病率及感兴趣的变量。进行卡方检验或独立样本t检验以确定存活者和死亡者之间是否存在差异。进行二元逻辑回归模型以预测HHC服务接受者的死亡率。

结果

HHC中死亡个体的平均年龄为78.3岁。超过20%接受HHC服务的个体再次入院。使用多变量回归分析,我们发现死亡率的最强预测因素是压疮,比值比为3.75,p值<0.0001,以及临床衰弱量表,比值比为1.69,p值为0.002。

结论与启示

总之,我们的研究发现压疮和衰弱是接受居家医疗保健服务个体死亡率的最强预测因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/064b/9464450/0c72d1a02a5d/JMDH-15-1997-g0001.jpg

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