Utilization of Hospice Care in Patients With Acute Ischemic Stroke
| Autor: | Yousef Hannawi, Archana Hinduja, Nabeel Chauhan, Syed F Ali |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Brain Ischemia Brain ischemia 03 medical and health sciences 0302 clinical medicine Altered Mental Status 030502 gerontology Diabetes mellitus Diabetes Mellitus Humans Medicine In patient Stroke Hospice care Retrospective Studies business.industry Smoking Age Factors Retrospective cohort study General Medicine medicine.disease Mental health Patient Discharge Hospice Care Mental Health Socioeconomic Factors Cardiovascular Diseases 030220 oncology & carcinogenesis Emergency medicine Female 0305 other medical science business |
| Zdroj: | American Journal of Hospice and Palliative Medicine®. 36:28-32 |
| ISSN: | 1938-2715 1049-9091 |
| DOI: | 10.1177/1049909118796796 |
| Popis: | Background: A significant percentage of terminally ill patients are discharged to hospice care following a devastating stroke. Objective: We sought to determine the factors associated with hospital discharge to hospice care in a large cohort of patients with stroke. Methods: Using the institutional Get With The Guidelines-Stroke database, all consecutive patients with acute ischemic stroke (AIS) who were alive at discharge, from January 2009 until July 2015, were analyzed. Univariate and multivariable statistical analyses were performed to determine the factors associated with discharge to hospice care. Results: Of 2446 patients with AIS, 3.4% died and were excluded of remaining 2363 patients, and 4.2% were discharged to hospice care. Univariate analysis identified patients who were discharged to hospice care to be older, caucasian, Medicare or private insurance, have atrial fibrillation, heart failure and less often had diabetes mellitus or smoked. Altered mentation at presentation and urinary tract infection were more common in patients discharged to hospice. On multivariable analysis, patients transferred to hospice care were older (odds ratio [OR]: 1.04, 95% confidence interval [CI]: 1.01-1.07; P < .001), had a high National Institute of Health Stroke Scale (NIHSS; OR: 1.15, 95% CI: 1.10-1.20; P < .001), and altered mental status at presentation (OR: 2.42, 95% CI: 1.29-4.55; P < .001). Conclusion: In our study, elderly patients with high NIHSS and altered mental status were identified as factors associated with transition to hospice care following AIS. Prospective studies on the optimal timing of initiation of these consults are needed. |
| Databáze: | OpenAIRE |
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