Nursing Home Admission and Home Care Initiation After Acute Aortic Dissection: A Nationwide Registry-Based Cohort Study.

IF 0.9 4区医学

Texas Heart Institute Journal Pub Date : 2024-12-12 eCollection Date: 2024-07-01 DOI:10.14503/THIJ-23-8366

Maria Weinkouff Pedersen, Riina Oksjoki, Jacob Eifer Møller, Anna Gundlund, Emil Fosbøl, Dorte Guldbrand Nielsen, Lars Køber, Mikkel Porsborg Andersen, Christian Torp-Pedersen, Peter Søgaard, Niels Holmark Andersen, Kristian Kragholm

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引用次数: 0

Abstract

Background: Little is known about long-term outcomes beyond survival following acute aortic dissection. The aim of this research was to evaluate rates of home care initiation and nursing home admission during the first year after discharge and to assess factors associated with these needs.

Methods: All patients in Denmark with a first-time diagnosis of acute aortic dissection type A or B between 2006 and 2015 were identified using national registries. Patients discharged alive without nursing home or home care use before aortic dissection were included, along with age-matched and sex-matched population controls without aortic dissection (at a ratio of 1:5). Cause-specific multivariable Cox regression was used to derive adjusted hazard ratios.

Results: The study population comprised 1093 patients and 5465 control individuals with a median (IQR) age of 64 (55-71) years; 70.6% were men. During their hospital stay, 2.7% of patients were registered with a first-time diagnosis of stroke, 7.1% with heart failure, and 2.2% with acute kidney failure; 5.9% of patients needed first-time dialysis. During the first year after discharge, 0.8% of patients who had had aortic dissection were admitted to a nursing home, 7.8% started home care, and 5.9% died. Among controls, these rates were 0.2%, 1.2%, and 1.2%, respectively. Patients who had had aortic dissection had significantly increased risk of initiating home care (hazard ratio, 7.47 [95% CI, 5.38-18.37]; P < .001) and of being admitted to a nursing home (hazard ratio, 4.28 [95% CI, 1.73-10.59]; P = .001). Initiation of home care and nursing home admission were related to advanced age, female sex, preexisting comorbidities, in-hospital complications, and conservative management of type A aortic dissection.

Conclusion: Only a small proportion of patients who survived an aortic dissection needed home care or nursing home admission after hospital discharge.

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急性主动脉夹层后入住养老院和开始家庭护理：一项基于全国登记的队列研究。

背景：对于急性主动脉夹层术后的长期预后知之甚少。本研究的目的是评估出院后第一年家庭护理的开始率和疗养院入院率，并评估与这些需求相关的因素。方法：2006年至2015年间，丹麦所有首次诊断为a型或B型急性主动脉夹层的患者均通过国家登记处进行鉴定。在主动脉夹层前没有养老院或家庭护理的活着出院的患者，以及年龄匹配和性别匹配的没有主动脉夹层的对照组（比例为1:5）。病因特异性多变量Cox回归得到调整后的风险比。结果：研究人群包括1093名患者和5465名对照个体，中位（IQR）年龄为64（55-71）岁；70.6%为男性。住院期间，2.7%的患者首次被诊断为中风，7.1%被诊断为心力衰竭，2.2%被诊断为急性肾衰竭；5.9%的患者需要首次透析。在出院后的第一年，0.8%的主动脉夹层患者住进了养老院，7.8%的患者开始了家庭护理，5.9%的患者死亡。在对照组中，这些比率分别为0.2%、1.2%和1.2%。有主动脉夹层的患者开始家庭护理的风险显著增加(风险比，7.47 [95% CI, 5.38-18.37]；P < 0.001)和入住养老院的风险(风险比4.28 [95% CI, 1.73-10.59]；P = .001)。开始家庭护理和入住养老院与高龄、女性、既往合并症、院内并发症和A型主动脉夹层的保守处理有关。结论：只有一小部分主动脉夹层存活患者出院后需要家庭护理或住进养老院。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Texas Heart Institute Journal CARDIAC & CARDIOVASCULAR SYSTEMS-

自引率

11.10%

发文量

131

期刊介绍： For more than 45 years, the Texas Heart Institute Journal has been published by the Texas Heart Institute as part of its medical education program. Our bimonthly peer-reviewed journal enjoys a global audience of physicians, scientists, and healthcare professionals who are contributing to the prevention, diagnosis, and treatment of cardiovascular disease. The Journal was printed under the name of Cardiovascular Diseases from 1974 through 1981 (ISSN 0093-3546). The name was changed to Texas Heart Institute Journal in 1982 and was printed through 2013 (ISSN 0730-2347). In 2014, the Journal moved to online-only publication. It is indexed by Index Medicus/MEDLINE and by other indexing and abstracting services worldwide. Our full archive is available at PubMed Central. The Journal invites authors to submit these article types for review: -Clinical Investigations- Laboratory Investigations- Reviews- Techniques- Coronary Anomalies- History of Medicine- Case Reports/Case Series (Submission Fee: $70.00 USD)- Images in Cardiovascular Medicine (Submission Fee: $35.00 USD)- Guest Editorials- Peabody’s Corner- Letters to the Editor