Institute of Biomedical Informatics, National Yang Ming Chiao Tung University, Hsinchu, Taiwan.
Division of Emergency Medical Service, New Taipei City Fire Department, New Taipei City, Taiwan.
Sci Rep. 2023 Mar 13;13(1):4145. doi: 10.1038/s41598-023-30868-6.
Patients with dementia are at increased risks of adverse consequences associated with motor vehicle crash injury (MVCI). However, studies of the association for patients with young-onset dementia (YOD) are limited. Therefore, we aim to investigate whether YOD was associated with adverse outcomes after hospitalization for MVCI. In this retrospective cohort study, we identified 2052 MVCI patients with YOD (aged 40-64 years) between 2006 and 2015 and included 10 260 matched MVCI patients without YOD (matching ratio: 1:5) from Taiwan's National Health Insurance Research Database and the Taiwan Police-Reported Traffic Accident Registry. We evaluated the intensive care unit (ICU) admission, organ failure, in-hospital and 30-day mortalities, length of hospital stay, and hospital costs. Compared with participants without dementia, patients with YOD had higher rates of ICU admission (34.31% vs. 20.89%) and respiratory failure (6.04% vs. 2.94%), with a covariate-adjusted odds ratio of 1.50 (95% CI 1.33-1.70) and 1.63 (95% CI 1.24-2.13), respectively. The patients also exhibited higher in-hospital mortality (4.73% vs. 3.12%) and 30-day mortality (5.12% vs. 3.34%) than their non-YOD counterparts, but the risk ratio was not significant after adjusting for transport mode. Moreover, the log means of hospital stay and cost were higher among patients with YOD (0.09 days; 95% CI 0.04-0.14 and NT$0.17; 95% CI 0.11-0.23, respectively). This cohort study determined that YOD may be adversely associated with hospital outcomes among MVCI patients. However, the association between YOD and mortality risk may depend on transport mode.
患有痴呆症的患者发生与机动车事故损伤(MVCI)相关的不良后果的风险增加。然而,针对早发性痴呆症(YOD)患者的相关研究有限。因此,我们旨在调查 YOD 是否与 MVCI 住院后的不良结局有关。在这项回顾性队列研究中,我们在 2006 年至 2015 年期间确定了 2052 名患有 YOD(年龄 40-64 岁)的 MVCI 患者,并从台湾全民健康保险研究数据库和台湾交通事故报告登记处纳入了 10260 名患有 YOD 的 MVCI 患者(匹配比例:1:5)。我们评估了重症监护病房(ICU)入院、器官衰竭、住院和 30 天死亡率、住院时间和住院费用。与无痴呆症的参与者相比,YOD 患者 ICU 入院率(34.31%比 20.89%)和呼吸衰竭率(6.04%比 2.94%)更高,调整后的比值比为 1.50(95%可信区间 1.33-1.70)和 1.63(95%可信区间 1.24-2.13)。YOD 患者住院死亡率(4.73%比 3.12%)和 30 天死亡率(5.12%比 3.34%)也高于非 YOD 患者,但调整交通方式后风险比无显著差异。此外,YOD 患者的住院时间和费用的对数平均值较高(0.09 天;95%可信区间 0.04-0.14 和新台币 0.17;95%可信区间 0.11-0.23)。这项队列研究确定 YOD 可能与 MVCI 患者的住院结局不良相关。然而,YOD 与死亡率风险之间的关联可能取决于交通方式。