Kaminski Tamar A, Murphy Terrence E, O'Leary John R, Leo-Summers Linda, Ferrante Lauren E
School of Medicine, Yale University, New Haven, Connecticut, United States.
Department of Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania, United States.
J Gerontol B Psychol Sci Soc Sci. 2025 Aug 23;80(9). doi: 10.1093/geronb/gbaf123.
Among older persons hospitalized in the intensive care unit (ICU) for critical illness, little is known about the health-related social needs (HRSNs) of food insecurity, social isolation, and transportation disadvantage in the year after discharge. This study aims to ascertain the prevalence of food insecurity, social isolation, and transportation disadvantage in the years preceding and following critical illness and to evaluate factors associated with each post-ICU HRSN.
Data from community-living participants in Rounds 2-9 of the National Health and Aging Trends Study (NHATS) 2011 cohort were linked to Medicare claims to identify ICU hospitalizations. HRSNs, demographics, preadmission, and in-hospital factors were drawn from NHATS and claims data. The prevalence of each HRSN was determined before and after critical illness. Factors associated with each HRSN in the year after discharge were evaluated using population-weighted multivariable logistic regression.
Among 450 participants, the mean age was 80.1 (SD 7.1), 50.9% were women, and 110 (24.7%) were non-Hispanic Black individuals. All three HRSNs increased in the year after critical illness (food insecurity, 4.9%-7.8%, social isolation, 31.9%-39.4%, and transportation disadvantage, 10.5%-15.6%). Socioeconomic disadvantage was associated with greater odds of social isolation after critical illness (adjusted odds ratio [aOR], 3.26; 95% CI, 1.38-7.70). Mechanical ventilation was associated with greater odds of post-ICU transportation disadvantage (aOR, 2.69; 95% CI, 1.03-7.01). No factors were significantly associated with post-ICU food insecurity.
These findings emphasize the need for screening and interventions to address HRSNs among older survivors of critical illness.
在因危重症入住重症监护病房（ICU）的老年人中，对于出院后一年内粮食不安全、社会孤立和交通不便等与健康相关的社会需求（HRSNs）了解甚少。本研究旨在确定危重症前后几年粮食不安全、社会孤立和交通不便的患病率，并评估与每种ICU后HRSN相关的因素。
将2011年队列的美国国家健康与老龄化趋势研究（NHATS）第2轮至第9轮社区居住参与者的数据与医疗保险理赔记录相链接，以识别ICU住院情况。HRSNs、人口统计学特征、入院前和住院期间的因素来自NHATS和理赔数据。确定每种HRSN在危重症前后的患病率。使用人口加权多变量逻辑回归评估出院后一年内与每种HRSN相关的因素。
在450名参与者中，平均年龄为80.1岁（标准差7.1），50.9%为女性，110名（24.7%）为非西班牙裔黑人。危重症后的一年里，所有三种HRSN都有所增加（粮食不安全从4.9%升至7.8%，社会孤立从31.9%升至39.4%，交通不便从10.5%升至15.6%）。社会经济劣势与危重症后社会孤立的几率增加相关（调整后的优势比[aOR]为3.26；95%置信区间为1.38 - 7.70）。机械通气与ICU后交通不便的几率增加相关（aOR为2.69；95%置信区间为1.03 - 7.01）。没有因素与ICU后粮食不安全显著相关。
这些发现强调了对危重症老年幸存者进行HRSNs筛查和干预的必要性。
