dementia increases the risks of acute organ dysfunction, severe sepsis and mortality in hospitalized older patients a national population-based study痴呆的风险增加急性器官功能障碍,严重脓毒症和死亡率住院老年患者一个国家以人群为基础的研究.pdfVIP

Dementia Increases the Risks of Acute Organ Dysfunction, Severe Sepsis and Mortality in Hospitalized Older Patients: A National Population-Based Study Hsiu-Nien Shen1,2*, Chin-Li Lu2,3, Chung-Yi Li2,4 1 Department of Intensive Care Medicine, Chi Mei Medical Center, Yong-Kang District, Tainan, Taiwan, 2 Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan, 3 Department of Medical Research, Chi Mei Medical Center, Yong-Kang District, Tainan, Taiwan, 4 Department of Public Health, China Medical University, Taichung, Taiwan Abstract Background: Dementia increases the risk of death in older patients hospitalized for acute illnesses. However, the effect of dementia on the risks of developing acute organ dysfunction and severe sepsis as well as on the risk of hospital mortality in hospitalized older patients remains unknown, especially when treatments for these life-threatening situations are considered. Methods: In this population-based cohort study, we analyzed 41,672 older ($65 years) patients, including 3,487 (8.4%) with dementia, from the first-time admission claim data between 2005 and 2007 for a nationally representative sample of one million beneficiaries enrolled in the Taiwan National Health Insurance Research Database. Outcomes included acute organ dysfunction, severe sepsis, and hospital mortality. The effect of dementia on outcomes was assessed using multivariable logistic regression. Results: Dementia was associated with a 32% higher risk of acute organ dysfunction (adjusted odds ratio [aOR] 1.32, 95% confidence interval [CI] 1.19–1.46), a 50% higher risk of severe sepsis (aOR 1.50, 95% CI 1.32–1.69) and a 28% higher risk of hospital mortality (aOR 1.28, 95% CI 1.10–1.48) after controlling age, sex, surgical condition, comorbidity, principal diagnosis, infection status, hospital level, a