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首页> 外文期刊>The Canadian Journal of Neurological Sciences: le Journal Canadien des Sciences Neurologiques >Sex Differences in Care Need and Survival in Patients Admitted to Nursing Home Poststroke
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Sex Differences in Care Need and Survival in Patients Admitted to Nursing Home Poststroke

机译：患者的护理需求和生存的性差异

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摘要

Background: Women are more likely to be admitted to nursing home after stroke than men. Differences in patient characteristics and outcomes by sex after institutionalization are less understood. We examined sex differences in the characteristics and care needs of patients admitted to nursing home following stroke and their subsequent survival. Methods: We identified patients with stroke newly admitted to nursing home between April 2011 and March 2016 in Ontario, Canada, with follow-up until March 2018 using linked administrative data. We calculated prevalence ratios and 95% confidence intervals (CIs) for the primary outcomes of dependence for activities of daily living, cognitive impairment, frailty, health instability, and symptoms of depression or pain, comparing women to men. The secondary outcome was all-cause mortality. Results: Among 4831 patients, 60.9% were women. Compared to men, women were older (median age [interquartile range, IQR]: 84 [78, 89] vs. 80 [71, 86]), more likely to be frail (prevalence ratio 1.14, 95% CI [1.08, 1.19]), have unstable health (1.45 [1.28, 1.66]), and experience symptoms of depression (1.25 [1.11, 1.40]) or pain (1.21 [1.13, 1.30]), and less likely to have aggressive behaviors (0.87 [0.80, 0.94]). Overall median survival was 2.9 years. In a propensity-score-matched cohort, women had lower mortality than men (hazard ratio 0.85, 95% CI [0.77, 0.94]), but in the age-stratified survival analysis, the survival advantage in women was limited to those aged 75 years and older. Conclusions: Despite lower subsequent mortality, women admitted to nursing home after stroke required more care than men. Pain and depression are two treatable symptoms that disproportionately affect women.
机译：背景：妇女更有可能被吹嘘后的养老院比男人在抚摸之后。制度化后，性别化后患者特征和结果的差异不太了解。我们检查了患者入住的患者的特点和护理需求的性别差异及其随后的生存。方法：在2011年4月2011年4月至2016年3月，在加拿大安大略省，我们鉴定了患有新入院的患者，以2016年3月，在2018年3月，使用链接的行政数据。我们计算了依赖日常生活，认知障碍，肥沃，健康不稳定和抑郁或疼痛症状的依赖的主要结果的普及比率和95％的置信区间（CIS）。二次结果是全部导致死亡率。结果：4831名患者中，60.9％是女性。与男性相比，女性较旧（中位年龄[四分位数范围，IQR]：84 [78,89]与80 [71,86]），更可能是虚弱的（流行比1.14,95％CI [1.08,19.19] ]），具有不稳定的健康状况（1.45 [1.28,1.66]），体验抑郁症状（1.25 [1.11,1.40]）或疼痛（1.21 [1.13,1.30]），不太可能具有侵略性行为（0.87 [0.80 [0.80] ，0.94]）。总中中位生存率为2.9岁。在倾向分数匹配的队列中，女性死亡率低于男性（危险比0.85,95％CI [0.77,0.94]），但在年龄分层的存活分析中，女性的生存优势仅限于75岁的人岁月和老年人。结论：尽管随后的死亡率较低，妇女在中风需要比男性所需的护理后录取养老院。疼痛和抑郁是两种可治疗的症状，不成比例地影响女性。

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