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21 家美国医疗机构中住院的痴呆症患者与年龄匹配对照者的 COVID-19 结局。

COVID-19 outcomes among patients with dementia and age-matched controls who were hospitalized in 21 US health-care systems.

机构信息

Center for Tobacco Research and Intervention, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin, USA.

Department of Medicine, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin, USA.

出版信息

Alzheimers Dement. 2024 Sep;20(9):6395-6406. doi: 10.1002/alz.14136. Epub 2024 Jul 29.

Abstract

INTRODUCTION

COVID-19 had devastating impacts worldwide. However, most research examining the impact of dementia on COVID-19 outcomes has been conducted in Europe and Asia and has not examined dementia subtypes.

METHODS

A retrospective analysis of electronic health record data from 21 US health-care systems examined relationships of all-cause dementia, Alzheimer's disease (AD), and vascular dementia with in-hospital mortality, intensive care unit (ICU) admission, and hospital stay duration.

RESULTS

All-cause dementia, but not AD or vascular dementia independently, was associated with increased mortality risk, the inclusion of discharge to hospice as a mortality equivalent increased risk for mortality for all-cause dementia, and AD and vascular dementia. Patients with all-cause dementia and AD were less likely to be admitted to the ICU than patients without. Patients with any form of dementia had longer hospital stays than patients without.

DISCUSSION

Dementia was associated with increased mortality or hospice discharge, decreased ICU admissions, and longer hospital stays.

HIGHLIGHTS

Only all-cause dementia was associated with increased mortality risk. This risk was lower than what has been published in previous research. Combining mortality and hospice discharge increased risk for all dementia subtypes. All-cause and Alzheimer's disease (AD) dementia were associated with decreased intensive care unit admissions. All-cause, vascular, and AD dementia were associated with longer hospital stays.

摘要

简介

COVID-19 在全球范围内造成了毁灭性的影响。然而,大多数研究痴呆症对 COVID-19 结果的影响的研究都是在欧洲和亚洲进行的,并未研究痴呆症的亚型。

方法

对来自 21 个美国医疗保健系统的电子健康记录数据进行回顾性分析,研究全因痴呆、阿尔茨海默病(AD)和血管性痴呆与住院死亡率、重症监护病房(ICU)入院率和住院时间的关系。

结果

全因痴呆症,但非 AD 或血管性痴呆症,与死亡率风险增加独立相关,将出院到临终关怀作为死亡率的等效物增加了全因痴呆症和 AD、血管性痴呆症的死亡率风险。与无痴呆症的患者相比,全因痴呆症和 AD 患者入住 ICU 的可能性较低。任何形式的痴呆症患者的住院时间都比无痴呆症患者长。

讨论

痴呆症与死亡率或临终关怀出院增加、ICU 入院减少和住院时间延长有关。

重点

只有全因痴呆症与死亡率风险增加相关。这一风险低于之前研究中报道的风险。将死亡率和临终关怀出院合并增加了所有痴呆症亚型的风险。全因和阿尔茨海默病(AD)痴呆症与 ICU 入院减少相关。全因、血管性和 AD 痴呆症与住院时间延长有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e288/11497724/120817d47692/ALZ-20-6395-g001.jpg

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