Rodríguez Henry Oliveros, Diaz-Dussan Natalia, Guzmán-Sabogal Yahira, Proaños Juliana, Tuta-Quintero Eduardo
School of Medicine, Universidad de La Sabana, Autonorte de Bogota Km 7, La Caro, Chía, Colombia.
Master's Candidate in Epidemiology, Universidad de La Sabana, Chía, Colombia.
Acta Neurol Belg. 2025 Mar 15. doi: 10.1007/s13760-025-02746-7.
Hospitalized patients with dementia exhibit high mortality rates, underscoring the importance of investigating variables associated with reduced survival. This study aims to determine the incidence of dementia among hospitalized patients and survival rates at 1 and 3 years post-hospitalization.
A retrospective cohort study was conducted using administrative databases from the Ministry of Health of Colombia. One- and three-year survival rates, along with adjusted hazard ratios for survival accounting for comorbidities included in the Charlson Index, were assessed using a Cox proportional hazards model. This analysis was performed for patients with dementia versus a control group without dementia. Additionally, findings were compared with those from an inverse propensity score weighting model.
6.769 (1.04%) patients were diagnosed with dementia, and 5798 (85.65%) were over 65 years of age. The unadjusted HR, the HR adjusted using the proportional hazards Cox model, and the HR obtained through propensity score matching (PSM) were 10.32 (95% CI 9.82 to 10.84), 1.69 (95% CI 1.60 to 1.78), and 1.32 (95% CI 1.02 to 1.71), respectively. The 1-year adjusted mortality rates for patients with dementia and those without were 12.5% and 1.31%, respectively, while the corresponding 3-year adjusted mortality rates were 21.25% and 2.76%. Through PSM, we determined that the mean survival time for patients with dementia, in comparison to those without, was - 0.98 months (95% CI: -0.65 to -1.94; p < 0.001).
Dementia significantly reduces survival rates of hospitalized patients, regardless of other comorbidities. Specifically, our research revealed that dementia was associated with a decrease in 3-year survival by an average of 0.98 months.
住院痴呆患者死亡率较高，这凸显了研究与生存时间缩短相关变量的重要性。本研究旨在确定住院患者中痴呆的发病率以及住院后1年和3年的生存率。
利用哥伦比亚卫生部的行政数据库进行了一项回顾性队列研究。使用Cox比例风险模型评估1年和3年生存率，以及考虑Charlson指数中合并症的生存调整风险比。对患有痴呆症的患者与无痴呆症的对照组进行了该分析。此外，将研究结果与逆倾向评分加权模型的结果进行了比较。
6769名（1.04%）患者被诊断为痴呆，5798名（85.65%）患者年龄超过65岁。未调整的风险比、使用比例风险Cox模型调整后的风险比以及通过倾向评分匹配（PSM）获得的风险比分别为10.32（95%置信区间9.82至10.84）、1.69（95%置信区间1.60至1.78）和和1.32（95%置信区间1.02至1.71）。痴呆患者和非痴呆患者的1年调整死亡率分别为12.5%和1.31%，而相应的3年调整死亡率分别为21.25%和2.76%。通过PSM，我们确定痴呆患者与非痴呆患者相比，平均生存时间缩短了0.98个月（95%置信区间：-0.65至-1.94；p<0.001）。
无论其他合并症如何，痴呆都会显著降低住院患者的生存率。具体而言，我们的研究表明，痴呆与3年生存率平均降低0.98个月有关。
