Incidence and main factors associated with early unplanned hospital readmission among French medical inpatients aged 75 and over admitted through emergency units.

Details

Serval ID
serval:BIB_28737080EA7F
Type
Article: article from journal or magazin.
Collection
Publications
Title
Incidence and main factors associated with early unplanned hospital readmission among French medical inpatients aged 75 and over admitted through emergency units.
Journal
Age and Ageing
Author(s)
Lanièce I., Couturier P., Dramé M., Gavazzi G., Lehman S., Jolly D., Voisin T., Lang P.O., Jovenin N., Gauvain J.B., Novella J.L., Saint-Jean O., Blanchard F.
ISSN
1468-2834 (Electronic)
ISSN-L
0002-0729
Publication state
Published
Issued date
2008
Peer-reviewed
Oui
Volume
37
Number
4
Pages
416-422
Language
english
Notes
Publication types: Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't Publication Status: ppublish
Abstract
BACKGROUND: among elderly patients, readmission in the month following hospital discharge is a frequent occurrence which involves a risk of functional decline, particularly among frail subjects. While previous studies have identified risk factors of early readmission, geriatric syndromes, as markers of frailty have not been assessed as potential predictors.
OBJECTIVE: to evaluate the risk of early unplanned readmission, and to identify predictors in inpatients aged 75 and over, admitted to medical wards through emergency departments.
DESIGN: prospective multi-centre study.
SETTING: nine French hospitals.
SUBJECTS: one thousand three hundred and six medical inpatients, aged 75 and older admitted through emergency departments (SAFES cohort).
METHODS: using logistic regressions, factors associated with early unplanned re-hospitalisation (defined as first unplanned readmission in the thirty days after discharge) were identified using data from the first week of hospital index stay obtained by comprehensive geriatric assessment.
RESULTS: data from a thousand out of 1,306 inpatients were analysed. Early unplanned readmission occurred in 14.2% of inpatients and was not related with sociodemographic characteristics, comorbidity burden or cognitive impairment. Pressure sores (OR = 2.05, 95% CI = 1.0-3.9), poor overall condition (OR = 2.01, 95% CI = 1.3-3.0), recent loss of ability for self-feeding (OR = 1.9, 95% CI = 1.2-2.9), prior hospitalisation during the last 3 months (OR = 1.6, 95% CI = 1.1-2.5) were found to be risk factors, while sight disorders appeared as negatively associated (OR = 0.5, 95% CI = 0.3--0.8).
CONCLUSIONS: markers of frailty (poor overall condition, pressure sores, prior hospitalisation) or severe disability (for self-feeding) were the most important predictors of early readmission among elderly medical inpatients. Early identification could facilitate preventive strategies in risk group.
Keywords
Acute Disease/epidemiology, Aged, Aged, 80 and over, Comorbidity, Emergency Service, Hospital/statistics & numerical data, Frail Elderly/statistics & numerical data, France/epidemiology, Geriatric Assessment, Geriatrics/statistics & numerical data, Health Status, Humans, Incidence, Logistic Models, Multivariate Analysis, Patient Readmission/statistics & numerical data, Risk Factors
Pubmed
Web of science
Open Access
Yes
Create date
15/04/2015 8:36
Last modification date
20/08/2019 13:07
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