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Table 3 Clinical Characteristics of Dying Facility Residents in Six European Countries (N = 1384)

From: Dying in long-term care facilities in Europe: the PACE epidemiological study of deceased residents in six countries

 

BE N = 291

NL N = 222

UK N = 91

FI N = 269

IT N = 200

PL N = 311

 

N(%)

N(%)

N(%)

N(%)

N(%)

N(%)

P-value*

Dementia at time of death (yes)abc

183 (62.9)

135 (61.4)

53 (60.2)

222 (82.5)

154 (77.0)

207 (67.9)

< 0.001

Stage of Dementia (based on CPS/GDSd) ab

 Moderate or mild dementia

27 (17.1)

29 (22.3)

13 (31.0)

43 (24.2)

14 (11.7)

17 (11.3)

0.676

 Severe dementia

48 (30.4)

41 (31.5)

11 (26.2)

57 (32.0)

40 (33.3)

37 (24.7)

 

 Very severe or advanced dementia

83 (52.5)

60 (46.2)

18 (42.9)

78 (43.8)

66 (55.0)

96 (64.0)

 

Diseases at time of deathbe

 Malignant cancerb

30 (15.5)

27 (18.5)

9 (42.9)

41 (19.4)

26 (17.2)

10 (4.0)

< 0.001

 Severe cardiovascular diseaseb

67 (34.7)

45 (30.8)

2 (9.5)

79 (37.4)

71 (47.0)

141 (55.7)

< 0.05

 Cerebrovascular accident (CVA)b

40 (20.7)

25 (17.1)

3 (14.3)

49 (23.2)

34 (22.5)

70 (27.7)

0.483

 Severe pulmonary diseaseb

33 (17.1)

17 (11.6)

3 (14.3)

17 (8.1)

40 (26.5)

18 (7.1)

< 0.001

 Severe neurological disease (not dementia)b

15 (7.8)

11 (7.5)

0 (0.0)

26 (12.3)

18 (11.9)

32 (12.6)

0.381

 Severe renal diseaseb

19 (9.8)

19 (13.0)

2 (9.5)

13 (6.2)

22 (14.6)

29 (11.5)

0.420

 Severe diabetesb

11 (5.7)

17 (11.6)

1 (4.8)

16 (7.6)

18 (11.9)

33 (13.0)

0.177

 Other severe diseaseb

31 (16.1)

4 (2.7)

3 (14.3)

51 (24.2)

33 (21.9)

33 (13.0)

< 0.001

Multimorbidities at time of deathb

 0–1 long-term conditions

94 (48.7)

77 (52.7)

10 (47.6)

72 (34.1)

39 (25.8)

98 (38.7)

0.268

 2 multimorbidities

54 (28.0)

40 (27.4)

8 (38.1)

68 (32.2)

52 (34.4)

102 (40.3)

 

 3 multimorbidities

30 (15.5)

25 (17.1)

2 (9.5)

49 (23.2)

37 (24.5)

40 (15.8)

 

 4 or more multimorbidities

15 (7.8)

4 (2.7)

1 (4.8)

22 (10.4)

23 (15.2)

13 (5.1)

 

Functional/cognitive status one month before death (BANS-S)af

 Mean (SD)

18.5 (4.9)

17.7 (4.7)

17.5 (4.2)

19.6 (4.3)

21.8 (3.7)

21.9 (4.6)

< 0.001

Cognitive Performance Scale one month before deathag

 (Borderline) Intact (score 0–1)

75 (28.0)

42 (20.5)

17 (23.3)

23 (9.4)

16 (9.9)

72 (11.6)

< 0.01

 Mild to moderate impairment (score 2–3)

55 (20.5)

58 (28.2)

21 (28.7)

56 (22.9)

27 (16.7)

37 (15.9)

 

 Moderately severe to very severe impairment (score 4–6)

138 (51.5)

105 (51.2)

35 (47.9)

165 (67.5)

118 (73.3)

169 (72.5)

 

Global Deterioration Scale Stage 7 one month before deathah

155 (57.8)

104 (47.5)

40 (50.6)

111 (48.3)

124 (66.0)

208 (73.2)

< 0.001

Clinical complications during last month of lifea

 Pneumoniaa

64 (24.2)

75 (37.7)

16 (21.6)

76 (31.4)

45 (25.3)

62 (21.2)

< 0.01

 Febrile episode (not pneumonia) a

118 (44.2)

36 (18.4)

4 (5.4)

78 (31.1)

98 (52.4)

136 (46.6)

< 0.001

 Eating or drinking problema

179 (65.3)

125 (60.4)

41 (51.9)

170 (66.4)

113 (60.8)

198 (66.4)

0.237

 Other clinical complications (e.g. stroke)a

96 (33.0)

81 (36.5)

38 (41.8)

65 (24.2)

81 (36.5)

113 (36.3)

< 0.05

  1. Percentages may not always add up to 100 because of rounding
  2. Missing values: dementia = 11, stage of dementia = 187 (419 not applicable because resident did not have dementia), diseases at time of death = 12, multimorbidities = 12, BANS-S = 86 missing data on at least one item, CPS = 182 (and 18 not applicable), GDS7 = 116, clinical complications = 81
  3. Abbreviations: CPS Cognitive Performance Scale, GDS Global Deterioration Scale, BANS-S Bedford Alzheimer Nursing Severity Scale
  4. *Generalised linear mixed model reporting p-value for country as a fixed effect, α =0.05. Significant results in bold
  5. aReported by staff member (nurse/care assistant) most involved in care
  6. bReported by treating physician (TP) For 397 out of 1384 residents no questionnaire was returned by the TP, these are not included as missing values below
  7. cWhen either the physician or the nurse (or both) considered the resident to have dementia, this was coded as yes
  8. dThe variable stage of dementia was based on the scores on the CPS and GDS, as answered by nursing staff, after selecting residents with dementia [16]
  9. eMultiple answers possible
  10. fScores on BANS-S range from 7 to 28; higher scores indicate greater severity
  11. gScores on CPS range from 0 to 6; higher scores indicate greater severity
  12. hScores on GDS range from 0 to 6; higher scores indicate greater severity
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BMC Public Health

ISSN: 1471-2458

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