Warren J L, Bacon W E, Harris T, McBean A M, Foley D J, Phillips C
Epidemiology Branch, Health Care Financing Administration, Baltimore, MD 21207.
Am J Public Health. 1994 Aug;84(8):1265-9. doi: 10.2105/ajph.84.8.1265.
Dehydration has been underappreciated as a cause of hospitalization and increased hospital-associated mortality in older people. This study used national data to analyze the burden and outcomes following hospitalizations with dehydration in the elderly.
Data from 1991 Medicare files were used to calculate rates of hospitalization with dehydration, to examine demographic characteristics and concomitant diagnoses associated with dehydration, and to analyze the contribution of dehydration to mortality.
In 1991, 6.7% (731,695) of Medicare hospitalizations had dehydration listed as one of the five reported diagnoses, a rate of 236.2/10,000 elderly Medicare beneficiaries. In 1991, Medicare reimbursed over $446 million for hospitalizations with dehydration as the principal diagnosis. Older people, men, and Blacks had elevated risks for hospitalization with dehydration. Acute infections, such as pneumonia and urinary tract infections, were frequent concomitant diagnoses. About 50% of elderly Medicare beneficiaries hospitalized with dehydration died within a year of admission.
Hospitalization of elderly people with dehydration is a serious and costly medical problem. Attention should be focused on understanding predisposing factors and devising strategies for prevention.
脱水作为老年人住院及医院相关死亡率增加的一个原因，一直未得到充分重视。本研究利用全国数据来分析老年人因脱水住院后的负担及后果。
使用1991年医疗保险档案数据来计算脱水住院率，检查与脱水相关的人口统计学特征及伴随诊断，并分析脱水对死亡率的影响。
1991年，6.7%（731,695例）的医疗保险住院病例将脱水列为报告的五项诊断之一，即每10,000名老年医疗保险受益人中有236.2例。1991年，医疗保险为以脱水作为主要诊断的住院病例报销了超过4.46亿美元。老年人、男性和黑人因脱水住院的风险较高。急性感染，如肺炎和尿路感染，是常见的伴随诊断。约50%因脱水住院的老年医疗保险受益人在入院一年内死亡。
老年人因脱水住院是一个严重且代价高昂的医疗问题。应将重点放在了解诱发因素及制定预防策略上。
