■来自不同社会文化背景和不同医疗条件的患者可能对高级护理计划和姑息治疗的接受程度不同。
■我们对2016年1月1日至2019年12月31日出院的国家住院患者样本进行了回顾性分析,这些患者的病情与经常的终末期病情相关。我们记录了人口统计变量,不复苏(DNR)状态,和姑息治疗(PC)状态,并分析结果之间的关联,死亡率,和停留时间(LOS)。
■本研究共纳入23,402,637份患者记录,其中2%是DNR和PC,5%是仅DNR,只有1%是PC。从2016年到2019年,PC患者的比例从2.55%增加到3.27%,DNR从6.31%增加到7.7%。黑人患者不太可能有DNR状态(比值比[OR]0.72[0.71-0.72]),但有相似的PC率。男性患者不太可能有DNR订单(OR0.89[0.89-0.89]),但更可能在PC中(OR1.05[1.04-1.05])。与DNR状态相关性最高的诊断为肺癌(OR4.1[4.0-4.5]),胰腺癌(OR4.6[4.5-4.7]),和败血症(OR2.9[2.9-2.9])与PC最相关的诊断是肺癌(OR6.3[6.2-6.4]),胰腺癌(OR8.1[7.1-8.3]),结肠癌(OR4.9[4.8-5.1]),和大脑的老年性脑变性OR6.5[5.3-7.9])。死亡率和LOS在2016年至2019年期间下降,但医院收费增加(p<0.001)。黑人种族和男性与较高的住院死亡率相关(OR1.12[1.12-1.14]),LOS,和医院费用。
■在美国,住院DNR患者的比例,PC,从2016年到2019年,PC的DNR有所增加。总的来说,住院死亡率和LOS下降,但是每个病人的住院费用增加了。出现了明显的性别和种族差异。黑人患者和男性患DNR的可能性较小,住院死亡率较高,LOS,和医院费用。
UNASSIGNED: Patients from diverse sociocultural backgrounds and with differing medical conditions may have varying levels of acceptance of advanced care planning and palliative care.
UNASSIGNED: We performed a retrospective analysis of the National Inpatient Sample for patients discharged from January 1, 2016, to December 31, 2019, with conditions associated with frequently terminal conditions. We recorded demographic variables, do not resuscitate (
DNR) status, and palliative care (PC) status and analyzed the associations between outcomes, mortality, and length of stay (LOS).
UNASSIGNED: A total of 23,402,637 patient records were included in the study, of which 2% were DNR and PC, 5% were
DNR only, and 1% was PC only. From 2016 to 2019, the percentage of patients with PC increased from 2.55% to 3.27% and DNR from 6.31% to 7.7%. Black patients were less likely to have
DNR status (odds ratio [OR] 0.72 [0.71-0.72]) but had similar PC rates. Male patients were less likely to have a
DNR order in place (OR 0.89 [0.89-0.89]) but more likely to be in PC (OR 1.05 [1.04-1.05]). The diagnoses with the highest association with DNR status were lung cancer (OR 4.1 [4.0-4.5]), pancreatic cancer (OR 4.6 [4.5-4.7]), and sepsis (OR 2.9 [2.9-2.9]) The diagnoses most associated with PC were lung cancer (OR 6.3 [6.2-6.4]), pancreatic cancer (OR 8.1 [7.1-8.3]), colon cancer (OR 4.9 [4.8-5.1]), and senile brain degeneration of the brain OR 6.5 [5.3-7.9]). Mortality and LOS decreased between 2016 and 2019, but hospital charges increased (p < 0.001). Black race and male gender were associated with higher inpatient mortality (OR 1.12 [1.12-1.14]), LOS, and hospital charges.
UNASSIGNED: In the United States, the proportion of hospitalized patients with DNR, PC, and
DNR with PC increased from 2016 to 2019. Overall, inpatient mortality and LOS fell, but hospital charges per patient increased. Significant gender and ethnic differences emerged. Black patients and males were less likely to have DNR status and had higher inpatient mortality, LOS, and hospital charges.