Nagura E, Igata A, Fujita H, Inoue T, Kanno K, Matsuura T, Tokuda H, Hosokawa T
Department of Internal Medicine, Chubu National Hospital.
Nihon Ronen Igakkai Zasshi. 1997 Jul;34(7):589-95. doi: 10.3143/geriatrics.34.589.
We compared bedridden elderly people living at home to others who were hospital inpatients. Questionnaires regarding medical status and care were returned by 85 of 116 people caring for a bedridden elderly person at home in Obu city, Aichi prefecture and by 62 of 64 nurses and family members caring for bedridden inpatients at Chubu National hospital. All subjects were at least 65 years old. The median age in both groups was 81 years, neither age distribution nor female sex predominance differed between both groups. The percentage of subjects with only one underlying disease was 62.5% among those living at home and 64.4% among inpatients. In both groups the most common disease was cerebrovascular disease (42.5% among those at home and 39.0% among inpatients), followed by dementia (31.3%), infirmity of old age (17.5%) and bone fracture (13.8%) among those at home, and by bone fracture (27.1%), dementia (20.3%) and infirmity of old age (16.9%) among inpatients. The median durations of bedridden status were 2 years and 3 months among those at home and 3 months among inpatients. The proportion of subjects bedridden for less than 6 months was greater among inpatients (p < 0.0001). The percentage who needed medical treatment was 60.0% among those at home and 67.7% among inpatients. The most common conditions for which drugs were taken were hypertension, dementia, chronic cerebrovascular dysfunction, and osteoporosis. Among inpatients, 54.8% were ambulatory before admission, 24.2% were almost completely bedridden, and 17.7% were completely bedridden. The most common cause rending the patients bedridden was infection (usually pneumonia). The degree of disability did not differ between groups. Decubitus ulcers were present in 25.9% of those at home and 17.7% of inpatients.
我们将居家卧床的老年人与住院患者进行了比较。爱知县大府市116名居家照顾卧床老人的人员中有85人、中部国立医院64名照顾卧床住院患者的护士及家属中有62人回复了有关医疗状况和护理的问卷。所有受试者年龄均在65岁及以上。两组的年龄中位数均为81岁,两组在年龄分布和女性占比方面均无差异。居家老人中仅患有一种基础疾病的受试者比例为62.5%,住院患者中这一比例为64.4%。两组中最常见的疾病均为脑血管疾病(居家老人中占42.5%,住院患者中占39.0%),其次居家老人中依次为痴呆(31.3%)、老年体弱(17.5%)和骨折(13.8%),住院患者中依次为骨折(27.1%)、痴呆(20.3%)和老年体弱(16.9%)。居家老人卧床状态的中位时长为2年零3个月,住院患者为3个月。住院患者中卧床时间不足6个月的受试者比例更高(p<0.0001)。居家老人中需要接受治疗的比例为60.0%,住院患者中为67.7%。最常服用药物治疗的疾病为高血压、痴呆、慢性脑血管功能障碍和骨质疏松症。住院患者中,54.8%在入院前能够行走,24.2%几乎完全卧床,17.7%完全卧床。导致患者卧床的最常见原因是感染(通常为肺炎)。两组之间的残疾程度无差异。居家老人中有25.9%出现压疮,住院患者中有17.7%出现压疮。