Abstract
Aim: The purpose of this study is to identify the factors affecting long-term prognosis of home-based medical care subjects. Methods: We evaluated 290 subjects, who received home-based medical care between January 2012 and May 2015. We evaluated several aspects of the activities of daily living, such as the ability to walk, use of the toilet, self-feeding and self-administering of medications, as well as their cognition, activities, and abilities to communicate. The influence of these parameters on major adverse cardiovascular cerebrovascular events, non-cardiovascular, cerebrovascular events and the incidence of death was evaluated. Results: The mean age of the subjects was 83 years old and 38% of them were male: dementia or previous cerebral infarction was their main diagnosis. They required assistance for almost all activities of daily living except for feeding. Primary health concerns included 103 (37.0%) subjects had non-cardiovascular, cerebrovascular events, 63 subjects (21.7%) had pneumonia, and 48 subjects (16.6%) suffered major adverse cardiovascular cerebrovascular events, including 22 subjects (7.6%) with congestive heart failure. Sixty-one subjects (21.0%) died. The activities of daily living and cognition correlated strongly with non-cardiovascular, cerebrovascular events and death. Conclusion: Our results indicated the activities of daily living and cognition strongly influence the occurrence of non-cardiovascular, cerebrovascular events and death in subjects receiving home-based medical care. Therefore, intervention should be targeted at improving these subjects' abilities to perform activities of daily living.
