Increased hospice enrollment and decreased neurosurgical interventions without changes in mortality for older Medicare patients with moderate to severe traumatic brain injury
| Autor: | Stephanie Nitzschke, Adil H. Haider, Ali Salim, Elizabeth J. Lilley, Zara Cooper, Samuel Enumah |
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| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Traumatic brain injury medicine.medical_treatment Poison control Medicare Logistic regression Neurosurgical Procedures 03 medical and health sciences 0302 clinical medicine Brain Injuries Traumatic Injury prevention medicine Humans 030212 general & internal medicine Aged Retrospective Studies Aged 80 and over Trauma Severity Indices business.industry 030208 emergency & critical care medicine General Medicine medicine.disease Gastrostomy United States Hospitalization Survival Rate Hospice Care Emergency medicine Cohort Female Surgery Neurosurgery business End-of-life care Follow-Up Studies |
| Zdroj: | The American Journal of Surgery. 215:1016-1019 |
| ISSN: | 0002-9610 |
| DOI: | 10.1016/j.amjsurg.2018.02.028 |
| Popis: | Background Hospice improves quality and value of end of life care (EOLC), and enrollment has increased for older patients dying from chronic medical conditions. It remains unknown if the same is true for older patients who die after moderate to severe traumatic brain injury (msTBI). Methods Subjects included Medicare beneficiaries (≥65 years) who were hospitalized for msTBI from 2005 to 2011. Outcomes included intensity and quality of EOLC for decedents within 30 days of admission, and 30-day mortality for the entire cohort. Logistic regression was used to analyze the association between year of admission, mortality, and EOLC. Results Among 50,342 older adults, 30-day mortality was 61.2%. Mortality was unchanged over the study period (aOR 0.93 [0.87–1.00], p = 0.06). Additionally, 30-day non-survivors had greater odds of hospice enrollment, lower odds of undergoing neurosurgery, but greater odds of gastrostomy. Conclusion Between 2005 and 2011, hospice enrollment increased, but there was no change in 30-day mortality. |
| Databáze: | OpenAIRE |
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