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首页> 外文期刊>The Journal of family practice >Which late-stage Alzheimer's patients should be referred for hospice care?
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Which late-stage Alzheimer's patients should be referred for hospice care?

机译:哪些晚期阿尔茨海默氏症患者应转诊接受临终关怀服务?

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摘要

Medicare guidelines are used to determine eligibility for hospice care (strength of recommendation [SOR]: C, based on expert opinion), but they correlate with 6-month mortality no better than an experienced clinician's judgment (SOR: B, based on 1 cohort study). Recent studies, however, have identified additional criteria that may better predict survival in select populations. These prognostic criteria include stepwise progression to Functional Assessment Staging Scale (FAST) stage 7c (inability to walk without assistance) (SOR: A, based on 2 small prospective cohort studies) and criteria derived from the Minimum Data Set (MDS) which include: dependency for activities of daily living, bedbound status, bowel incontinence, comorbid conditions (specifically cancer, congestive heart failure, oxygen dependence, or dyspnea), medical instability, eating <25% of meals, sleeping most of the day, male gender, and age >83 years (SOR: B, based on a large retrospective cohort study).
机译:Medicare指南用于确定是否接受临终关怀服务的资格(根据专家的意见,推荐强度[SOR]:C),但它们与6个月死亡率的相关性并不比有经验的临床医生的判断更好(SOR:B,基于1个队列)研究)。但是,最近的研究确定了其他标准,可以更好地预测某些人群的生存情况。这些预后标准包括逐步发展到功能评估分阶段量表(FAST)的7c级(无助走动不能行走)(SOR:A,基于2项小型前瞻性队列研究)和从最低数据集(MDS)得出的标准,包括:对日常生活活动的依赖,床位状态,肠失禁,合并症(特别是癌症,充血性心力衰竭,氧气依赖或呼吸困难),医疗不稳定,进餐<25%,全天大部分时间睡眠,男性和年龄> 83岁(SOR:B,基于一项大型回顾性队列研究)。

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