The Research Centre for Age-related Functional Decline and Disease, Innlandet Hospital Trust, Norway.
Centre for Age-related Medicine, Stavanger University Hospital, Norway.
Scand J Public Health. 2024 Mar;52(2):159-165. doi: 10.1177/14034948221140195. Epub 2022 Dec 6.
Nursing home (NH) residents are in their last phase of life, and two aims of the NH's medical care in Norway is to prevent unnecessary hospital admissions that would not benefit the resident and to facilitate a peaceful death in familiar surroundings when the time comes. However, little is known about the share of residents dying in NHs and the causes of death. We therefore evaluated the cause and place of death in a cohort of NH residents followed from the time of NH admission until death.
NH residents were followed from admission to the NH and over the entire course of their NH stay. Demographic and clinical data were collected. Cause and place of death were retrieved from the Norwegian Cause of Death Registry.
Of 1283 residents, 6.2% died in hospital and 91.2% in a NH. Those who died in hospitals were more often male, died sooner after NH admission, had a less severe degree of dementia and had poorer general health. Dementia was the most common underlying cause of death, followed by cardiovascular disease.
Dementia is one of the main causes of death in NH residents. In addition, our findings indicate a low number of inappropriate referrals to hospital during the last stage of life. However, further research should explore whether the terminal phase of NH residents is formed in accordance with their preferences and whether appropriate palliative care is offered.
养老院（NH）的居民处于生命的最后阶段，挪威 NH 医疗的两个目标是预防对居民无益的不必要住院治疗，并在适当的时候在熟悉的环境中促进和平死亡。然而，对于 NH 中死亡居民的比例和死因知之甚少。因此，我们评估了从 NH 入院到死亡的 NH 居民队列的死因和死亡地点。
NH 居民从 NH 入院开始一直跟踪到 NH 入住期间的整个过程。收集人口统计学和临床数据。从挪威死因登记处检索死因和死亡地点。
在 1283 名居民中，有 6.2%的居民在医院死亡，91.2%的居民在 NH 死亡。在医院死亡的患者更多为男性，NH 入院后死亡时间更早，痴呆程度较轻，一般健康状况较差。痴呆是 NH 居民死亡的主要原因之一，其次是心血管疾病。
痴呆是 NH 居民死亡的主要原因之一。此外，我们的研究结果表明，在生命的最后阶段，NH 居民的住院治疗数量较少，没有不必要的转诊。然而，还需要进一步研究，以探讨 NH 居民的临终阶段是否符合他们的意愿，以及是否提供适当的姑息治疗。
