Risk Factors for Mortality in a Cohort of Older Adults Receiving Home Nursing Care in Taiwan

Background: This study aimed to examine causes of death and related risk factors among older adults receiving home nursing care in Taiwan. Methods: This retrospective cohort study examined data a hospital's home-care initial assessment, admission charts, and death certificates, examining the period from 2010 to 2016. The individuals analyzed were first-time recipients of home nursing services, which they had been receiving for ≥ 90 days. Data analyzed in the initial assessment included Barthel Index, Norton Scale, and Eastern Cooperative Oncology Group Scale of Performance Status scores, and details regarding tube placement. Kaplan-Meier curves were generated and analyzed for all causes of mortality, and multivariate Cox proportional hazards models were used to identify risk factors. Results: Overall, 1,010 patients were analyzed. Their median age was 81.95 years, and 583 (57.72%) were women. The median duration of home nursing care was 536 days. During the follow-up period, 437 patients (43.27%) died, with a mortality rate of 223.80/1,000 person years. After adjustment with Cox proportional hazard regression models, patients with higher Eastern Cooperative Oncology Group Scale of Performance Status scores (hazard ratio 1.70, p value ＜ 0.01) or lower Barthel Index scores (hazard ratio 1.94, p value ＜ 0.01) showed higher mortality rates. Conclusion: Patients receiving home nursing care with higher Eastern Cooperative Oncology Group Scale of Performance Status scores or lower Barthel Index scores showed higher mortality risk.