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Aging Clinical and Experimental Research

, Volume 27, Issue 6, pp 883–891 | Cite as

Predictive factors for early unplanned rehospitalization of older adults after an ED visit: role of the caregiver burden

  • Sylvie Bonin-Guillaume
  • Anne-Claire DurandEmail author
  • Fadila Yahi
  • Marielle Curiel-Berruyer
  • Oceana Lacroix
  • Elodie Cretel
  • Marc Alazia
  • Roland Sambuc
  • Stephanie Gentile
Original Article

Abstract

Background and aims

For older adults, an Emergency Department (ED) visit represents a period of vulnerability that extends beyond the visit itself. This study aimed to determine the impact of the role of caregiver, and geriatric conditions of patients on early unplanned rehospitalization (EUR) within 3 months after an ED visit.

Methods

This prospective longitudinal experimental study included consecutively 173 patients aged 75 and older admitted in an ED over a 2-week period (18.7 % of the total visits). Only older patients having a caregiver were analyzed (78.0 %, n = 135). Medical conditions and a comprehensive geriatric assessment were recorded for each patient. All caregivers were interviewed about their tasks and emotional impact using the short Zarit Burden Inventory. Three months after, patients or their caregivers were called about the vital status, and EUR of patients.

Results

Among the patients included, 64.2 % had an EUR and 28.9 % of their caregivers reported a high level of burden. EUR was strongly associated with a high caregiver burden (OR 8.7, 95 % CI 1.5–49.8). No association was found for patient’s medical or geriatric status. Caregivers reported a significantly high burden when patients were malnourished, or were at risk of adverse health outcomes based on the ISAR scale, and when they had greater disabilities in IADLs and ADLs, or cognitive impairments.

Conclusions

Many hospital readmissions after an ED visit may be preventable by identifying caregiver’s high burden. Reasons that lead to this high burden should be checked at the first visit.

Keywords

Caregiving Caregiver burden Emergency department Hospitalization Older patient 

Notes

Conflicts of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Ethical standards

This study involved human participants and has been approved by two national ethics committees, the Advisory Committee on Health Research Information (“Comité Consultatif sur le Traitement de l’Information en matière de Recherche dans le domaine de la Santé”) and the National Commission on Informatics and Freedom (“Commission Nationale Informatique et Liberté”) and performed in accordance with ethical standards.

Informed consent

All patients and their caregiver signed informed consent before inclusion to the procedure.

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Copyright information

© Springer International Publishing Switzerland 2015

Authors and Affiliations

  • Sylvie Bonin-Guillaume
    • 1
    • 2
  • Anne-Claire Durand
    • 3
    Email author
  • Fadila Yahi
    • 3
  • Marielle Curiel-Berruyer
    • 3
  • Oceana Lacroix
    • 4
  • Elodie Cretel
    • 4
  • Marc Alazia
    • 5
  • Roland Sambuc
    • 3
  • Stephanie Gentile
    • 3
  1. 1.Service de Médecine Interne GériatrieHôpitaux Sud, Assistance Publique Hôpitaux de MarseilleMarseilleFrance
  2. 2.Institut des Neurosciences Timone, UMR-CNRS 7289Aix-Marseille UniversitéMarseilleFrance
  3. 3.Laboratoire de Santé Publique, EA 3279, Faculté de MédecineAix-Marseille UniversitéMarseilleFrance
  4. 4.Unité Mobile de GériatrieHôpital La Timone Adultes, Assistance Publique Hôpitaux de MarseilleMarseilleFrance
  5. 5.Service d’Accueil des UrgencesAssistance Publique Hôpitaux de MarseilleMarseilleFrance

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