Retrospective analysis of events of death at home among patients under follow-up observation

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Abstract


Aim. To study the peculiarities of asking for medical care by patients from among those dead at home, who had been under follow-up observation.

Materials and methods. The data, received from ambulatory medical records of 100 dead at home patients with follow-up, were analyzed using the methods of descriptive and inductive statistics.

Results. A mean age of death was 74.9 ± 13.4 years, men – 65.8 ± 14.1 years, women – 79.2 ± 10.9 years. Cardiovascular diseases were the cause of follow-up observation in 78 % of cases and the cause of death in 85 %; in 30 % of patients the disease was detected while carrying out prophylactic medical examination. A mean duration of disease by the moment of death was 13.0 ± 8.0 years, among pensioners 13.7 ± 8.5 years, in able-bodied  persons 9.6 ± 4.3 years. A mean duration of follow-up observation was 9.2 ± 5.8 years. An average number of planned visits was 2.8 ± 0.89, but the number of real visits during the last year of follow-up observation was 2.4 ± 1.2. Disability was registered in 77.6 % of patients, concomitant diseases – in all patients. For the last year, exacerbations were recorded in 92 % of patients, emergency calls – in 80 %, hospitalization events – 52 %, including 55.8 % – urgent ones.

Conclusions. The absence of significant difference regarding the duration of disease between pensioners and able-bodied patients (т = 0.16, р = 1.43) as well as the absence of correlation between the age and duration of disease (χ2 = 0.19, p = 0.2) indirectly prove the influence of duration of disease on its outcome, but not the age. Attendance, characterizing clinical loyalty to treatment, does not depend on age (χ2 = –0.19,  р = 0.18), sex (т = 1.0, р = 0.32), way of detecting disease (f = 0.9, p = 0.4), class of main disease (f = 0.91,  p = 0.44), duration of disease (χ2 = –0.13, р = 0.49), exacerbations (χ2 = –0.17, р = 0.24), concomitant diseases (χ2 = 0.006, р = 0.9). The number of emergency calls, hospitalizations, urgent hospitalizations does not depend on duration of follow-up observation, regularity and number of real visits to a doctor (p > 0.05) that indicates unsatisfactory quality of follow-up observation.


Ya. P. Sandakov

Author for correspondence.
Sand_2004@mail.ru
Diagnostic Center № 3 of Moscow Healthcare Department
Russian Federation, Moscow

кандидат медицинских наук, заместитель главного врача по медицинской части

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