Risk Factors for Mortality in a Cohort of Older Adults Receiving Home Nursing Care in Taiwan

Te-Ming Chiang ； Meng-Ting Tsou ； Hsin-Hui Shao ； Lee-Ching Hwang

《International Journal of Gerontology》 13卷4期 (2019/12) Pp. 298-304

https://doi.org/10.6890/IJGE.201912_13(4).0007

摘要

Background: This study aimed to examine causes of death and related risk factors among older adults receiving home nursing care in Taiwan. Methods: This retrospective cohort study examined data a hospital's home-care initial assessment, admission charts, and death certificates, examining the period from 2010 to 2016. The individuals analyzed were first-time recipients of home nursing services, which they had been receiving for ≥ 90 days. Data analyzed in the initial assessment included Barthel Index, Norton Scale, and Eastern Cooperative Oncology Group Scale of Performance Status scores, and details regarding tube placement. Kaplan-Meier curves were generated and analyzed for all causes of mortality, and multivariate Cox proportional hazards models were used to identify risk factors. Results: Overall, 1,010 patients were analyzed. Their median age was 81.95 years, and 583 (57.72%) were women. The median duration of home nursing care was 536 days. During the follow-up period, 437 patients (43.27%) died, with a mortality rate of 223.80/1,000 person years. After adjustment with Cox proportional hazard regression models, patients with higher Eastern Cooperative Oncology Group Scale of Performance Status scores (hazard ratio 1.70, p value ＜ 0.01) or lower Barthel Index scores (hazard ratio 1.94, p value ＜ 0.01) showed higher mortality rates. Conclusion: Patients receiving home nursing care with higher Eastern Cooperative Oncology Group Scale of Performance Status scores or lower Barthel Index scores showed higher mortality risk.

關鍵字

activities of daily living ； home nursing ； mortality ； Taiwan ； World Health Organization