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Early re-hospitalization of elderly people discharged from a geriatric ward

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Abstract

Background and aims: Hospitalized elderly patients generally have a high level of disability and comorbidity. In many cases, at hospital discharge, the achieved health status balance is poor, and consequently the risk of further disability and hospital readmission is great. Identifying factors leading to hospital readmission could be helpful in reducing such events. The aim of the study was to evaluate the incidence and predictive factors of hospital readmission. Methods: We conducted an observational cohort study of a group of patients discharged from the Geriatric Ward of the San Giovanni Battista Hospital, Torino (Italy). The study sample contained 839 patients aged 80.6±6.3 years. The average hospital stay was 17.5±18.9 days (range 1–274 days). Results: Follow-up lasted three months, at the end of which 107 patients (12.8%) had been readmitted, 83 (9.9%) had only one readmission and 24 (2.9%) one or more readmissions. The first readmission took place within 15 days of discharge for 24 patients (2.9%) and within 30 days of discharge for 27 (3.2%). A new hospital admission within 15 days of discharge increased the risk of mortality (RR=3) and also the probability of a second re-hospitalization. 10.1% patients died; 88.2% of the patients who died had at least one readmission, whereas only 4.2% of live patients had a new hospital admission. Conclusions: Tumors, dementia, comorbidity, high education level, day hospital course and period of convalescence were all significantly and independently related to readmission.

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References

  1. Inouye SK, Peduzzi PN, Robinson JT, Hughes JS, Horwitz RI, Concato J. Importance of functional measures in predicting mortality among older hospitalized patients. JAMA 1998; 279: 1187–93.

    Article  PubMed  CAS  Google Scholar 

  2. Mor V, Wilcox V, Rakowski W, Hiris J. Functional transition among the elderly: patterns, predictors, and related hospital use. Am J Public Health 1994; 84: 1274–80.

    Article  PubMed  CAS  Google Scholar 

  3. Boult C, Dowd B, McCaffrey D, Boult L, Hernandez R, Krule-witch H. Screening elders for risk of hospital admission. J Am Geriatr Soc 1993; 41: 811–7.

    PubMed  CAS  Google Scholar 

  4. Antilla SK. Diseases and symptoms as predictors of hospital care in an aged population: a prospective register-based study. Scan J Soc Med 1992; 20: 79–84.

    Google Scholar 

  5. Victor CR, Vetter NJ. The early readmission of elderly to hospital. Age Ageing 1985; 14: 37–42.

    Article  PubMed  CAS  Google Scholar 

  6. Colledge NR. Ford MJ. The early readmission of elderly people Scott Med J 1994; 39: 51–2

    PubMed  CAS  Google Scholar 

  7. Tierney AJ, Worth A. Review: readmission of elderly patients to hospital. Age Ageing 1995; 24: 163–6.

    Article  PubMed  CAS  Google Scholar 

  8. Caplan GA, Brown A, Croker WD, Doolan J. Risk of admission within 4 weeks of discharge of elderly patients from the emergency department — the DEED study. Age Ageing 1998; 27: 697–702.

    Article  PubMed  CAS  Google Scholar 

  9. Chu LW, Pei CKW. Risk factors for early emergency hospital readmission in elderly medical patients. Gerontology 1999; 45: 220–8.

    Article  PubMed  CAS  Google Scholar 

  10. Pearson B, Skelly R, Wileman D, Masud T. Unplanned readmission to hospital: a comparison of the views of general practitioners and hospital staff. Age Ageing 2002; 31: 141–3.

    Article  PubMed  Google Scholar 

  11. Lotus Shyu YI, Chen MC, Lee HC. Caregiver’s needs as predictors of hospital readmission for the elderly in Taiwan. Soc Sci Med 2004; 58: 1395–403.

    Article  PubMed  Google Scholar 

  12. Lawton MP, Brody EM. Assessment of older people: self-maintaining and instrumental activities of daily living. Geront 1969; 9: 179–86.

    Article  CAS  Google Scholar 

  13. Katz S. Downs TD, Cash HR, Grotz RC. Progress in development of the index of ADL. Geront 1970; 1: 20–30.

    Article  Google Scholar 

  14. Pfeiffer E. A short portable mental status questionnaire for assessment of organic brain deficit in elderly patients. J Am Geriatr Soc 1975; 23: 433–41.

    PubMed  CAS  Google Scholar 

  15. Fabris F, Molaschi M, Ponzetto M, Fonte G, Visentin P, Scarafiotti C. Dependence Medical Index (DMI) in elderly persons: a tool for identification of dependence for medical reasons. BOLD 1996; 2: 9–12.

    Google Scholar 

  16. Romano PS, Roos LL, Jollis JG. Adapting a clinical comorbidity index for use with ICD-9 CM administrative data: differing perspectives. J Clin Epidemiol 1993; 46:1075–9.

    Article  PubMed  CAS  Google Scholar 

  17. Rosenfeld T, Fahey P, Price M, Leeder S. The fate of elderly patients discharged from the accident and emergency department of a general teaching hospital. Community Health Stud 1990; 14: 365–72.

    Article  PubMed  CAS  Google Scholar 

  18. Marcantonio ER, Mckean S, Goldfinger M, Kleffield S, Yurkofsky M, Brennan TA. Factors associated with unplanned hospital readmission among patients 65 years of age and older in a Medicare Managed Care Plan. Am J Med 1999; 107: 13–7.

    Article  PubMed  CAS  Google Scholar 

  19. Turner JF, Main A, Carpenter GL. Casemix resource use and geriatric medicine in England and Wales. Age Ageing 1995; 24: 1–4.

    Article  PubMed  CAS  Google Scholar 

  20. Rubenstein LZ, Wieland D, Bernabei R. Geriatric assessment technology: the state of the art. Milano: Ed. Kurtis, 1995: 75–88.

    Google Scholar 

  21. Victor C. Jefferies S. Are readmission rates a useful indicator of outcome? Geriatr Med 1990; March: 19–20.

  22. Wolinsky FD, Culler SD, Callahan CM, Johnson RJ. Hospital resource consumption among older adults: a prospective analysis of episodes, length of stay, and charges over a seven-year period. J Gerontol 1994; 49: S240–52.

    Article  PubMed  CAS  Google Scholar 

  23. Mateev A, Gaspoz JM, Borst F, Waldvogel F, Weber D. Use of a short-form screening procedure to detect unrecognized functional disability in the hospitalized elderly. J Clin Epidemiol 1998; 51: 309–14.

    Article  PubMed  CAS  Google Scholar 

  24. Karppi P. Effects of a geriatric inpatient unit on elderly home care patients: a controlled trial. Aging Clin Exp Res 1995; 7: 207–11.

    Article  CAS  Google Scholar 

  25. Walter LC, Brand RJ, Counsell SR, et al. Development and validation of a prognostic index for 1-year mortality in older adults after hospitalisation. JAMA 2001; 285: 2987–94.

    Article  PubMed  CAS  Google Scholar 

  26. Williams ME, Gaylord SA, Gerrity MS. The timed manual performance test as a predictor of hospitalization and death in a community-based elderly population. J Am Geriatr Soc 1994; 42: 21–7.

    PubMed  CAS  Google Scholar 

  27. Weiler PG. Lubben JE. Chi I. Cognitive impairment and hospital use. Am J Public Health 1991; 81: 1153–7.

    Article  PubMed  CAS  Google Scholar 

  28. Binder EF, Robins LN. Cognitive impairment and length of hospital stay in older persons. J Am Geriatr Soc 1990; 38: 759–66.

    PubMed  CAS  Google Scholar 

  29. Zanocchi M, Maero B, Francisetti F, et al. Multidimensional assessment and risk factors for prolonged hospitalization in the elderly. Aging Clin Exp Res 2003; 15: 305–9.

    PubMed  Google Scholar 

  30. Parkes J, Shepperd S. Discharge planning from hospital to home. Cochrane Database Syst Rev 2002: CD000313.

  31. Ania BJ, Suman VJ, Fairbanks VF, Rademacher DM, Melton LJ. Incidence of anemia in older people: an epidemiologic study in a well defined population J Am Geriatr Soc 1997; 45: 825–31.

    PubMed  CAS  Google Scholar 

  32. Balducci L, Stanta G. Cancer in the frail patient. A coming epidemic. Hematol Oncol Clin North Am 2000; 14: 235–50.

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Geriatric Section, Medical and Surgical Department, University of Torino, C.so Bramante 88, 10126, Torino, Italy

    Mauro Zanocchi MD, Barbara Maero, Elisa Martinelli, Flavio Cerrato, Laura Corsinovi, Elisabetta Ponte, Angela Luppino, Angela Margolicci & Mario Molaschi

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  1. Mauro Zanocchi MD
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  2. Barbara Maero
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  3. Elisa Martinelli
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  4. Flavio Cerrato
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  5. Laura Corsinovi
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  6. Mafalda Gonella
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  7. Elisabetta Ponte
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  8. Angela Luppino
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  9. Angela Margolicci
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  10. Mario Molaschi
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Zanocchi, M., Maero, B., Martinelli, E. et al. Early re-hospitalization of elderly people discharged from a geriatric ward. Aging Clin Exp Res 18, 63–69 (2006). https://doi.org/10.1007/BF03324642

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  • DOI: https://doi.org/10.1007/BF03324642

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