姑息治疗中的痴呆症患者，依据德国国家临终关怀和姑息治疗登记处的数据（2009-2021 年）。
Dementia patients in palliative care according to data from the German National Hospice and Palliative Care Register (2009-2021).
机构信息
Center for Health Services Research in Medicine, Department of Psychiatry and Psychotherapy, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Schwabachanlage 6, 91054, Erlangen, Germany.
Department of Palliative Medicine & Comprehensive Cancer Center, CCC Erlangen - EMN, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Krankenhausstraße 12, 91054, Erlangen, Germany.
出版信息
BMC Palliat Care. 2024 Jul 25;23(1):185. doi: 10.1186/s12904-024-01509-0.
BACKGROUND
People with dementia are less in focus of palliative care research than other patient groups even though the awareness of their palliative and end-of-life care needs is rising. Empirical data analyses on people with dementia in palliative care services are lacking.
AIM
To explore the prevalence of dementia diagnoses as per the ICD criteria among users of various palliative care settings and to compare use of palliative services, care pathways, and outcomes in people with and without a dementia diagnosis.
DESIGN
We conducted retrospective analysis of dementia diagnoses as per ICD (F00-F03/G30) in the German National Hospice and Palliative Care Register between 2009 and 2021. The analysis used methods of descriptive and inferential statistics, including the Bonferroni correction for alpha error inflation.
SETTING/PARTICIPANTS: We limited the analysis to the subsample of people aged over 64.
RESULTS
The prevalence of dementia in the different settings of palliative care was lower than in the age-comparable population: Of the 69,116 data sets included in the analysis, a small minority (3.3%) was coded with dementia as the principal diagnosis. Among patients on inpatient palliative care wards, 0.8% (148 of 19,161) had a dementia diagnosis, as did 2.2% (52 of 2,380) of those under hospital palliative care support teams and 4.3% (2,014 of 46,803) of those receiving specialized palliative care at home.
CONCLUSIONS
The records of the German National Hospice and Palliative Care Register suggest that the prevalence of dementia is lower than one might expect from general population data, though numbers are in line with international studies on proportion of dementia patients receiving palliative care. Future research could usefully examine whether this discrepancy stems either from omissions in coding dementia as patients' principal diagnosis respectively from lapses in documentation of a dementia diagnosis previously made, or from barriers to accessing palliative care services or even displays being excluded from palliative care when trying to access it.
TRIAL REGISTRATION
No registration.
背景
痴呆症患者在姑息治疗研究中的关注度低于其他患者群体，尽管人们对他们的姑息治疗和临终关怀需求的认识正在提高。在姑息治疗服务中，针对痴呆症患者的实证数据分析仍然缺乏。
目的
根据国际疾病分类（ICD）标准，探讨各种姑息治疗环境中痴呆症诊断的患病率，并比较有和无痴呆症诊断的患者对姑息治疗服务、护理途径和结局的使用情况。
设计
我们对 2009 年至 2021 年德国国家临终关怀和姑息治疗登记处中根据 ICD（F00-F03/G30）进行的痴呆症诊断进行了回顾性分析。该分析采用描述性和推断性统计方法，包括对 alpha 错误膨胀的 Bonferroni 校正。
设置/参与者：我们将分析仅限于年龄超过 64 岁的子样本。
结果
姑息治疗不同环境中的痴呆症患病率低于年龄匹配人群：在纳入分析的 69116 个数据集中，只有一小部分（3.3%）被编码为主要诊断为痴呆症。在住院姑息治疗病房的患者中，0.8%（19161 人中的 148 人）有痴呆症诊断，在接受医院姑息治疗支持团队治疗的患者中为 2.2%（2380 人中的 52 人），在接受专门家庭姑息治疗的患者中为 4.3%（46803 人中的 2014 人）。
结论
德国国家临终关怀和姑息治疗登记处的记录表明，痴呆症的患病率低于从一般人群数据中预期的水平，尽管这一数字与国际上关于接受姑息治疗的痴呆症患者比例的研究一致。未来的研究可以有效地探讨这种差异是源于对痴呆症作为患者主要诊断的编码遗漏，还是源于姑息治疗服务获取方面的障碍，甚至是在试图获得姑息治疗时被排除在姑息治疗之外。
试验注册
无注册。
Zotero 插件