| 谭黎峰
，吴晔
，张晓凡.痴呆晚期患者死亡因素预测分析[J].神经损伤功能重建,2019,14(11):551-556 |
| 痴呆晚期患者死亡因素预测分析 |
| Analysis of Clinical Risk Factors for Death in Advanced Dementia Patients |
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| DOI： |
| 中文关键词: 痴呆 死亡 危险因素 |
| 英文关键词: dementia death risk factors |
| 基金项目: |
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| 中文摘要: |
| 目的：探讨能预测痴呆晚期患者死亡的风险因素，建立适合住院重度痴呆患者死亡的预测模型。方 法：回顾性分析痴呆患者144例，按是否死亡分为存活组81例和死亡组63例。对影响痴呆患者死亡的危险
因素先后进行单因素分析及二分类Logistic 回归分析，建立痴呆患者死亡预测模型，并对模型进行校准度及
辨别能力检验。结果：死亡组患者年龄较长（P<0.05），痴呆起病较晚（P<0.05），痴呆病程较短（P<0.05）；存
活组患者受教育程度较高（P<0.05），既往合并高血压比例较高（P<0.05）。存活组的肺部感染、发热、白细胞
异常、电解质异常、血糖异常、肝肾功能异常和水肿发生率均显著低于死亡组（P=0.000），血红蛋白、白蛋白
水平均显著高于死亡组（P=0.000），总蛋白水平低于死亡组（P=0.012）。存活组吃饭、穿脱衣、上厕所和行走
能力高于死亡组（P<0.05）。肺部感染、血红蛋白值、既往合并高血压、行走、起病年龄和白细胞异常，为重度
痴呆患者死亡预测风险因素。 预测模型拟合度好。结论：肺部感染、低血红蛋白值、高血压、行走、起病年龄
和白细胞异常，为重度痴呆患者死亡预测风险因素 ，其中高血压和血红蛋白为保护性因素。 |
| 英文摘要: |
| To explore the risk factors for death in patients with advanced dementia and to establish
a prediction model for death risk in these patients. Methods: Total 144 dementia patients were retrospectively
analyzed and divided into discharge group (81 patients) and death group (63 patients) based on their survival.
Death risk analysis model for advanced dementia patients was established by univariate and Logistic regression
analysis, and its degree of calibration and discriminating power were tested. Results: Patients in the death group
were older and had a later onset and shorter course of dementia (all P<0.05). Patients in the discharge group had
a higher education level (P<0.05) and a higher proportion with hypertension (P<0.05). Univariate analysis found
that patients in the discharge group had lower incidence of pulmonary infection, fever, leukocyte abnormality,
electrolyte abnormality, blood sugar abnormality, liver and kidney function abnormality, and edema than those in
the death group (P=0.000); levels of hemoglobin and albumin were significantly higher than those in the death
group (P=0.000), and the total protein level was lower than that in the death group (P=0.012). The ability of
eating, dressing, going to the toilet, and walking in the discharge group was higher than that in the death group
(P<0.05). Logistic regression analysis showed that pulmonary infection, hemoglobin value, previous
hypertension, walking ability, age at onset, and abnormal white blood cells were risk factors for death in patients
with advanced dementia. The predictive model had excellent goodness of fit. Conclusion: The risk factors in
the death risk model for patients with advanced dementia include pulmonary infection, low hemoglobin value,
history of hypertension, walking ability, age of onset, and leukocyte abnormality; among these, history of
hypertension and hemoglobin value are protective factors. |
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