Mortality and Discharge Location of Intensive Care Patients With Alzheimer Disease and Related Dementia.

Background: Intensive care unit (ICU) utilization has increased among patients with Alzheimer disease and related dementia (ADRD), although outcomes are poor. Objectives: To compare ICU discharge location and subsequent mortality between patients with and patients without ADRD enrolled in Medicare A...

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Publicado en:American Journal of Critical Care Vol. 32; no. 4; pp. 249 - 256
Autores principales: Davis-Ajami, Mary Lynn, Chang, Chiang-Hua, Gupta, Sumedha, Khan, Babar Ali, Solid, Craig A., El Sharu, Husam, Boustani, Malaz, Yates, Brandon A., Simon, Kosali
Formato: research tables/charts Journal Article
Publicado: American Association of Critical-Care Nurses Jul2023
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Jul2023
      vid: 32
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      pub: American Association of Critical-Care Nurses
      place: Alisa Veijo, California
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        atl: Mortality and Discharge Location of Intensive Care Patients With Alzheimer Disease and Related Dementia.
      aug:
        au:
          Davis-Ajami, Mary Lynn
          Chang, Chiang-Hua
          Gupta, Sumedha
          Khan, Babar Ali
          Solid, Craig A.
          El Sharu, Husam
          Boustani, Malaz
          Yates, Brandon A.
          Simon, Kosali
        affil: Mary Lynn Davis-Ajami is chair and professor, Department of Nursing, Merrimack College, North Andover, Massachusetts
      sug:
        subj:
          Mortality Evaluation
          Patient Discharge Evaluation
          Critically Ill Patients
          Alzheimer's Disease
          Intensive Care Units
          Dementia
          Human
          Male
          Female
          Nonexperimental Studies
          Aged
          Aged, 80 and Over
          Medicare
          Insurance Coverage
          Descriptive Statistics
          Comparative Studies
          Odds Ratio
          Confidence Intervals
          Life Expectancy
          Aged: 65+ years
          Aged, 80 & over
          Male
          Female
      ab: Background: Intensive care unit (ICU) utilization has increased among patients with Alzheimer disease and related dementia (ADRD), although outcomes are poor. Objectives: To compare ICU discharge location and subsequent mortality between patients with and patients without ADRD enrolled in Medicare Advantage. Methods: This observational study used Optum's Clinformatics Data Mart Database from years 2016 to 2019 and included adults aged >67 years with continuous Medicare Advantage coverage and a first ICU admission in 2018. Alzheimer disease and related dementia and comorbid conditions were identified from claims. Outcomes included discharge location (home vs other facilities) and mortality (within the same calendar month of discharge and within 12 months after discharge). Results: A total of 145 342 adults met inclusion criteria; 10.5% had ADRD and were likely to be older, female, and have more comorbid conditions. Only 37.6% of patients with ADRD were discharged home versus 68.6% of patients who did not have ADRD (odds ratio [OR], 0.40; 95% CI, 0.38-0.41). Both death in the same month as discharge (19.9% vs 10.3%; OR, 1.54; 95% CI, 1.47-1.62) and death in the 12 months after discharge (50.8% vs 26.2%; OR, 1.95; 95% CI, 1.88-2.02) were twice as common among patients with ADRD. Conclusions: Patients with ADRD have lower home discharge rates and greater mortality after an ICU stay than patients without ADRD.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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