Kostev Karel, Michalowsky Bernhard, Bohlken Jens
Epidemiology, IQVIA, 60549 Frankfurt, Germany.
University Clinic, Philipps-University, 35043 Marburg, Germany.
Brain Sci. 2024 Apr 30;14(5):455. doi: 10.3390/brainsci14050455.
Studies have reported higher in-hospital mortality rates in patients living with dementia (PlwD) with limited evidence across age groups, clinical departments, and admission diagnoses. The aim of this study was to compare the in-hospital mortality rate of PlwD with patients without dementia across groups, clinical departments, and admission diagnoses.
This case-control study included patients aged ≥ 60 years hospitalized in 1 of 14 German hospitals between January 2019 and July 2023. PlwD were matched to patients without dementia. The associations between dementia and in-hospital mortality across groups were assessed using univariable logistic regression analyses.
15,956 patients with and 15,956 without dementia were included (mean age: 83.9 years, 60.7% female). PlwD had a significantly higher in-hospital mortality rate (14.0% vs. 11.7%; OR 1.24, 95% CI: 1.16-1.32) than non-dementia controls. The highest excess mortality rate was observed in the youngest age group (60-70 years: 10.9% vs. 5.7%; OR: 2.05, 95% CI: 1.30-3.24), decreased with age, and became non-significant in the oldest age group (≥90 years: 16.2% vs. 17.3%; OR: 0.93, 95% CI: 0.80-1.08). Significant differences were found for digestive system disorders (OR: 1.59; 95% CI: 1.15-1.89), cardiovascular and cerebrovascular disorders (OR: 1.51; 95% CI: 1.30-1.75), endocrine, nutritional, and metabolic diseases (OR: 1.42; 95% CI: 1.06-1.90), and pneumonia (OR: 1.20; 95% CI: 1.04-1.37), as well as for all clinic departments except for geriatric departments.
The excess mortality rate was highest in younger age groups, where the general mortality and complication rate is relatively low in the general population. Appropriate approaches are needed, especially in non-geriatric wards.
研究报告称，痴呆症患者（PlwD）的院内死亡率较高，但各年龄组、临床科室和入院诊断方面的证据有限。本研究的目的是比较不同组、临床科室和入院诊断的PlwD与非痴呆症患者的院内死亡率。
这项病例对照研究纳入了2019年1月至2023年7月期间在德国14家医院之一住院的≥60岁患者。将PlwD与非痴呆症患者进行匹配。使用单变量逻辑回归分析评估痴呆症与各组院内死亡率之间的关联。
纳入了15956例有痴呆症患者和15956例无痴呆症患者（平均年龄：83.9岁，60.7%为女性）。PlwD的院内死亡率显著高于非痴呆症对照组（14.0%对11.7%；OR 1.24，95%CI：1.16 - 1.32）。在最年轻的年龄组（60 - 70岁：10.9%对5.7%；OR：2.05，95%CI：1.30 - 3.24）中观察到最高的额外死亡率，随年龄降低，在最年长的年龄组（≥90岁：16.2%对17.3%；OR：0.93，95%CI：0.80 - 1.08）中变得不显著。在消化系统疾病（OR：1.59；95%CI：1.15 - 1.89）、心血管和脑血管疾病（OR：1.51；95%CI：1.30 - 1.75）、内分泌、营养和代谢疾病（OR：1.42；95%CI：1.06 - 1.90）以及肺炎（OR：1.20；95%CI：1.04 - 1.37）中发现了显著差异，除老年科外的所有临床科室均如此。
额外死亡率在较年轻年龄组中最高，而该年龄组在普通人群中的总体死亡率和并发症发生率相对较低。需要采取适当的方法，特别是在非老年病房。
