Patel Nirmal, Tyagi Rahul, Biswas Deepanwita, Birjees Ayesha, Rajesh Chetana, Khan Sadia
Internal Medicine, St. George's University School of Medicine, West Indies, GRD.
Family Medicine, Leeds General Practitioner Confederation, Leeds, GBR.
Cureus. 2023 Dec 28;15(12):e51245. doi: 10.7759/cureus.51245. eCollection 2023 Dec.
Anorexia nervosa is a severe and occasionally fatal eating disorder characterized by extreme weight loss and a distorted body image in which the affected individuals typically exhibit a strong fear of gaining weight, leading to rigid dietary restrictions and excessive activity. This condition can cause severe health problems, such as hunger, cardiovascular issues, and organ destruction. Anorexia nervosa is a key subject for research in the context of end-of-life care disparities due to its psychological and physical challenges. Aims: This study examines differences in the places of death for people with anorexia nervosa during a 22-year period in the USA, taking into account four important factors: age group, gender, race, and U.S. census region.
Data were collected from the CDC WONDER website on August 31, 2023, and spans years 1999 to 2020, using the particular ICD-11 code F50.0 for anorexia nervosa. The study aims to uncover the important determinants impacting the location of death within this specific population using sophisticated statistical methods, including univariate logistic regression.
The analysis of aggregate data yielded notable findings. The patient's principal site of death was at home or in hospice care. Other sites were less prevalent, with medical facilities or nursing homes ranking second. The place of death was highly influenced by age groups with diverse patterns. Gender had no significant impact; however, geographical inequalities were noticeable. Individuals in the Northeast, Midwest, and South were less likely than those in the West to die at home or in hospice care. The location of death was unaffected by race.
In conclusion, this study found that death in home and hospice was more common than in medical or hospital nursing facilities in all four analyzed groups. These findings highlight the critical need for significant advancements in end-of-life care, particularly in home and hospice settings.
神经性厌食症是一种严重的、有时甚至会致命的饮食失调症,其特征是体重极度减轻和身体形象扭曲,患者通常表现出强烈的体重增加恐惧,从而导致严格的饮食限制和过度活动。这种情况会引发严重的健康问题,如饥饿、心血管问题和器官损害。由于其心理和生理挑战,神经性厌食症是临终关怀差异研究的一个关键课题。目的:本研究考察了美国22年间神经性厌食症患者死亡地点的差异,同时考虑了四个重要因素:年龄组、性别、种族和美国人口普查区域。
2023年8月31日从美国疾病控制与预防中心(CDC)的WONDER网站收集数据,数据涵盖1999年至2020年,使用国际疾病分类第11版(ICD - 11)中神经性厌食症的特定代码F50.0。该研究旨在使用复杂的统计方法,包括单变量逻辑回归,揭示影响这一特定人群死亡地点的重要决定因素。
汇总数据分析得出了显著发现。患者的主要死亡地点是在家中或临终关怀机构。其他地点则不太常见,医疗设施或养老院位列第二。死亡地点受年龄组的影响很大,呈现出不同的模式。性别没有显著影响;然而,地域不平等较为明显。东北部、中西部和南部地区死于家中或临终关怀机构的可能性低于西部地区。死亡地点不受种族影响。
总之,本研究发现,在所有四个分析组中,在家中和临终关怀机构死亡比在医疗或医院护理设施中更为常见。这些发现凸显了临终关怀,尤其是在家中和临终关怀环境中取得重大进展的迫切需求。