Predictors of hospital readmission rate in geriatric patients.
Aging Clin Exp Res
; 36(1): 22, 2024 Feb 07.
Article
em En
| MEDLINE
| ID: mdl-38321332
ABSTRACT
BACKGROUND:
Hospital readmissions among older adults are associated with progressive functional worsening, increased institutionalization and mortality.AIM:
Identify the main predictors of readmission in older adults.METHODS:
We examined readmission predictors in 777 hospitalized subjects (mean age 84.40 ± 6.77 years) assessed with Comprehensive Geriatric Assessment (CGA), clinical, anthropometric and biochemical evaluations. Comorbidity burden was estimated by Charlson Comorbidity Index (CCI). Median follow-up was 365 days.RESULTS:
358 patients (46.1%) had a second admission within 365 days of discharge. Estimated probability of having a second admission was 0.119 (95%C.I. 0.095-0.141), 0.158 (95%C.I. 0.131-0.183), and 0.496 (95%C.I. 0.458-0.532) at 21, 30 and 356 days, respectively. Main predictors of readmission at 1 year were length of stay (LOS) > 14 days (p < 0.001), albumin level < 30 g/l (p 0.018), values of glomerular filtration rate (eGFR) < 40 ml/min (p < 0.001), systolic blood pressure < 115 mmHg (p < 0.001), CCI ≥ 6 (p < 0.001), and cardiovascular diagnoses. When the joint effects of selected prognostic variables were accounted for, LOS > 14 days, worse renal function, systolic blood pressure < 115 mmHg, higher comorbidity burden remained independently associated with higher readmission risk.DISCUSSION:
Selected predictors are associated with higher readmission risk, and the relationship evolves with time.CONCLUSIONS:
This study highlights the importance of performing an accurate CGA, since defined domains and variables contained in the CGA (i.e., LOS, lower albumin and systolic blood pressure, poor renal function, and greater comorbidity burden), when combined altogether, may offer a valid tool to identify the most fragile patients with clinical and functional impairment enhancing their risk of unplanned early and late readmission.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Readmissão do Paciente
/
Hospitalização
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article