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肺动脉高压终末期治疗的位置

Location of Terminal Care in Pulmonary Hypertension.

作者信息

Ibrahim Ramzi, Habib Adam, Olson April, Shrourou Farah, Pham Hoang Nhat, Abdelnabi Mahmoud, Neyestanak Maryam Emami, Soin Sabrina, Low See-Wei, Natt Bhupinder, Mamas Mamas A, Barry Timothy, Ayoub Chadi, Arsanjani Reza, Rischard Franz P, Lee Kwan

机构信息

Department of Cardiovascular Medicine, Mayo Clinic, Phoenix, Arizona, USA.

Department of Medicine, University of Arizona-Tucson, Tucson, Arizona, USA.

出版信息

CJC Open. 2025 Apr 15;7(6):832-839. doi: 10.1016/j.cjco.2025.03.026. eCollection 2025 Jun.

Abstract

BACKGROUND

Death locations for individuals in the US is influenced by social factors. Pulmonary hypertension (PH) is an uncommon condition, with a substantial impact on morbidity and mortality. We evaluated the patterns in and impact of demographics on PH death locations in the US.

METHODS

From 2005 to 2020, our study identified PH-related deaths through the CDC repository. Patient-level demographic data for the year 2019 were directly queried from the CDC. Locations of death were categorized into 4 groups, as follows: inpatient; outpatient and/or emergency room (ER); home; and hospice and/or nursing facilities. Linear regression models were used to assess trends in proportion of deaths across these locations. Multivariable logistic regression models examined the influence of demographics on the likelihood of death occurring in each location.

RESULTS

Between 2005 and 2020, a rise occurred in the proportion of deaths at home (β = 0.006, < 0.001) and in hospice and/or nursing facilities (β = 0.005, < 0.001). The odds of dying at home or in hospice and/or nursing facilities increased with age ( < 0.001). Male decedents were more likely than female decedents to die in an outpatient and/or ER setting (odds ratio [OR] 1.22, = 0.047) and at home (OR 1.16, = 0.005). Compared to White decedents, Black decedents had higher odds of death in the inpatient (OR 1.99, < 0.001) and the outpatient and/or ER (OR 1.38, = 0.007) settings, but lower odds of death at home (OR 0.63, < 0.001) or in hospice and/or nursing facilities (OR 0.46, < 0.001).

CONCLUSIONS

Our analysis revealed a significant difference in the locations of death for patients with PH in recent years, as influenced by demographic factors.

摘要

背景

在美国,个体的死亡地点受社会因素影响。肺动脉高压(PH)是一种罕见疾病,对发病率和死亡率有重大影响。我们评估了美国肺动脉高压患者死亡地点的模式及其人口统计学影响。

方法

2005年至2020年期间,我们的研究通过疾病控制与预防中心(CDC)资料库确定了与肺动脉高压相关的死亡病例。2019年患者层面的人口统计学数据直接从疾病控制与预防中心查询。死亡地点分为以下4组:住院;门诊和/或急诊室(ER);家中;临终关怀机构和/或护理机构。使用线性回归模型评估这些地点死亡比例的趋势。多变量逻辑回归模型研究了人口统计学对每个地点死亡可能性的影响。

结果

2005年至2020年期间,在家中死亡的比例(β = 0.006,P < 0.001)以及在临终关怀机构和/或护理机构死亡的比例(β = 0.005,P < 0.001)有所上升。在家中或临终关怀机构和/或护理机构死亡的几率随年龄增加而增加(P < 0.001)。男性死者在门诊和/或急诊室环境中死亡的可能性高于女性死者(优势比[OR] 1.22,P = 0.047),在家中死亡的可能性也更高(OR 1.16,P = 0.005)。与白人死者相比,黑人死者在住院环境(OR 1.99,P < 0.001)以及门诊和/或急诊室(OR 1.38,P = 0.007)环境中死亡的几率更高,但在家中(OR 0.63,P < 0.001)或临终关怀机构和/或护理机构(OR 0.46,P < 0.001)中死亡的几率较低。

结论

我们的分析显示,近年来受人口统计学因素影响,肺动脉高压患者的死亡地点存在显著差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/01a8/12198618/47fdac1ef691/ga1.jpg

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