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医院相关残疾患者的死亡率结局及相关危险因素

Mortality Outcomes and Contributing Risk Factors in Patients with Hospital-Associated Disability.

作者信息

Jo Soo-Jeong, Lee So-Hee, Min Hyo-Jin, Kim Hee-Ji, Kong Hyun-Ho

机构信息

Department of Rehabilitation Medicine, Chungbuk National University Hospital, Cheongju 28644, Republic of Korea.

Department of Clinical Pharmacology and Therapeutics, Chungbuk National University Hospital, Cheongju 28644, Republic of Korea.

出版信息

J Clin Med. 2024 Aug 15;13(16):4798. doi: 10.3390/jcm13164798.

Abstract

: Hospital-associated disability (HAD), a functional decline following acute hospitalization, is a common complication associated with mortality and unfavorable prognoses in patients admitted to acute care hospitals. However, few studies have investigated mortality and associated factors in patients with HAD and have been limited by inconsistent HAD assessment tools and criteria. This study investigated mortality and risk factors in patients with HAD using specific criteria. : This retrospective study evaluated patients referred to the Department of Rehabilitation Medicine with suspected HAD between June 2022 and March 2023. The collected data included medical histories, diagnostic tests for HAD (including muscle strength, balance, and modified Barthel Index), and bioelectrical impedance analysis (BIA). Multivariate logistic regression analysis was conducted to identify factors associated with mortality. Kaplan-Meier survival curves were constructed for mortality at 3 and 7 months. : A total of 455 patients were identified, among which 206 patients diagnosed with HAD (73.1 ± 12.5 years) were included in the analysis. The 3-month mortality rate was 27.2%. In the multivariate analysis, male sex (odds ratio (OR), 3.23; < 0.01), a history of cancer (OR, 2.18; < 0.05), and a low phase angle (OR, 0.69; < 0.05) were significantly associated with mortality. A phase angle < 2.9° on BIA was associated with a significant increase in 3-month (hazard ratio (HR), 1.85; 95% confidence interval (CI), 1.06-3.23) and 7-month (HR, 2.80; 95% CI, 1.75-4.98) mortality. : Patients with HAD had a high mortality rate, with several factors, particularly low BIA phase angles, associated with increased mortality.

摘要

医院相关残疾(HAD)是急性住院后出现的功能衰退,是急性护理医院收治患者中与死亡率和不良预后相关的常见并发症。然而,很少有研究调查HAD患者的死亡率及相关因素,并且这些研究受到HAD评估工具和标准不一致的限制。本研究使用特定标准调查了HAD患者的死亡率及危险因素。

这项回顾性研究评估了2022年6月至2023年3月间因疑似HAD转诊至康复医学科的患者。收集的数据包括病史、HAD诊断测试(包括肌肉力量、平衡和改良巴氏指数)以及生物电阻抗分析(BIA)。进行多因素逻辑回归分析以确定与死亡率相关的因素。构建了3个月和7个月死亡率的Kaplan-Meier生存曲线。

共识别出455例患者,其中206例被诊断为HAD的患者(73.1±12.5岁)纳入分析。3个月死亡率为27.2%。在多因素分析中,男性(比值比(OR),3.23;<0.01)、癌症病史(OR,2.18;<0.05)和低相位角(OR,0.69;<0.05)与死亡率显著相关。BIA上相位角<2.9°与3个月(风险比(HR),1.85;95%置信区间(CI),1.06 - 3.23)和7个月(HR,2.80;95%CI,1.75 - 4.98)死亡率的显著增加相关。

HAD患者死亡率较高,有几个因素,特别是低BIA相位角,与死亡率增加相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/24c6/11355630/99b03eb08e45/jcm-13-04798-g001.jpg

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