Risk factors of mortality among the home-based disabled patients in central Taiwan

Abstract

The objective of this study was to investigate the factors that affected mortality 1 year after an intensive service program among the disabled. Three hundred and twenty-two disabled subjects were selected from communities in central Taiwan. Sixty-six percent of the participants had cerebral vascular accident (CVA) followed by hypertension (28%) and diabetes mellitus (20%). After 1 year, 117 (36.3%) had died. The activities of daily living (ADL) scores of the participants who had died were significantly lower than those in the survival group. Of those who had pressure sores, 60% were in the ‘death group’ compared with about 40% in the survival group. Overall, mortality rate was 36.3% after the intensive service program. Based on multiple logistic regression, the factors that affected mortality were as follows: age over 65 years compared with less than 64 years (adjust odds ratio (AOR)=1.897), severe ADL dependence (AOR=0.502), incidence of CVA (AOR=0.448), and pressure sores (AOR=1.978). The authors recommend that the factors affecting mortality be evaluated urgently and that medical services and community support systems cooperate to provide disabled patients with adequate health care. In addition, the implementation of the intensive service program provides an opportunity and challenge for nurses to examine their working practices.