Unplanned transfer to acute care during inpatient geriatric rehabilitation: incidence, risk factors, and associated short-term outcomes.

Details

Serval ID
serval:BIB_EE03F897055B
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Unplanned transfer to acute care during inpatient geriatric rehabilitation: incidence, risk factors, and associated short-term outcomes.
Journal
BMC geriatrics
Author(s)
Fernandes S., Bula C., Krief H., Carron P.N., Seematter-Bagnoud L.
ISSN
1471-2318 (Electronic)
ISSN-L
1471-2318
Publication state
Published
Issued date
24/05/2024
Peer-reviewed
Oui
Volume
24
Number
1
Pages
456
Language
english
Notes
Publication types: Journal Article
Publication Status: epublish
Abstract
Information is scarce on unplanned transfers from geriatric rehabilitation back to acute care despite their potential impact on patients' functional recovery. This study aimed 1) to determine the incidence rate and causes of unplanned transfers; 2) to compare the characteristics and outcomes of patients with and without unplanned transfer.
Consecutive stays (n = 2375) in a tertiary geriatric rehabilitation unit were included. Unplanned transfers to acute care and their causes were analyzed from discharge summaries. Data on patients' socio-demographics, health, functional, and mental status; length of stay; discharge destination; and death, were extracted from the hospital database. Bi- and multi-variable analyses investigated the association between patients' characteristics and unplanned transfers.
One in six (16.7%) rehabilitation stays was interrupted by a transfer, most often secondary to infections (19.3%), cardiac (16.8%), abdominal (12.7%), trauma (12.2%), and neurological problems (9.4%). Older patients (AdjOR <sub>age≥85</sub> : 0.70; 95%CI: 0. 53-0.94, P = .016), and those admitted for gait disorders (AdjOR: 0.73; 95%CI: 0.53-0.99, P = .046) had lower odds of transfer to acute care. In contrast, men (AdjOR: 1.71; 95%CI: 1.29-2.26, P < .001), patients with more severe disease (AdjOR <sub>CIRS</sub> : 1.05; 95%CI: 1.02-1.07, P < .001), functional impairment before (AdjOR: 1.69; 95%CI: 1.05-2.70, P = .029) and at rehabilitation admission (AdjOR: 2.07; 95%CI: 1.56- 2.76, P < .001) had higher odds of transfer. Transferred patients were significantly more likely to die than those without transfer (AdjOR 13.78; 95%CI: 6.46-29.42, P < .001) during their stay, but those surviving had similar functional performance and rate of home discharge at the end of the stay.
A significant minority of patients experienced an unplanned transfer that potentially interfered with their rehabilitation and was associated with poorer outcomes. Men, patients with more severe disease and functional impairment appear at increased risk. Further studies should investigate whether interventions targeting these patients may prevent unplanned transfers and modify associated adverse outcomes.
Keywords
Humans, Male, Female, Patient Transfer/trends, Patient Transfer/methods, Aged, Aged, 80 and over, Risk Factors, Incidence, Rehabilitation Centers/trends, Inpatients, Time Factors, Treatment Outcome, Retrospective Studies, Length of Stay/trends, Length of Stay/statistics & numerical data, Acute transfers, Geriatrics, Infections, Rehabilitation, Risk factors
Pubmed
Web of science
Open Access
Yes
Create date
27/05/2024 8:53
Last modification date
08/06/2024 6:58
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