Perfil epidemiológico e preditores de mortalidade de pessoas idosas assistidas por serviço de assistência domiciliar: estudo de coorte de 3 anos (2019-2022)

Abstract

Objective: The aim was to characterize the epidemiological profile and identify the predictors of mortality in older adults assisted by a home care service. Methodology and Casuistry: A cohort study was conducted from November 2019 to October 2022, involving 212 older adults aged 60 or above in São Paulo State, Brazil, who were receiving low to moderate complexity home care services. The data collection involved demographic and clinical variables. The Cox proportional hazards models were employed for analyzing mortality predictors, executing both univariate and multivariate analyses. Results: The participants had an average age of 82.9 years, with a majority being female (64.1%). The predominant admission diagnoses were stroke (38.7%) and dementia (31.1%). A significant portion (66%) were on five or more medications, and 78.8% were dependent on assistance for basic daily activities. The study observed a 59.9% mortality rate, mainly due to cardiovascular diseases (21.3%) and senile/neurodegenerative diseases (22.8%). Age ≥ 80 years (Hazard ratio [HR]=1.57, p=0.026), COVID-19 diagnosis (HR=1.72, p=0.008), and dependency on drug administration (HR=2.81, p=0.029) were associated with a higher mortality risk. Conclusion: The study highlights advanced age, reliance on medication administration, and COVID-19 diagnosis as significant mortality risk factors in elderly patients under home care. These findings emphasize the necessity for customized treatment regimes, efficient medication management, and stringent COVID-19 preventive measures to optimize care for this vulnerable population.