Differential risk factors for early and later hospital readmission of older patients

Abstract

In a medicalized population of older people, several risk factors may be identified for 0-1 month and 2-3 month readmission. Besides severe morbidities at discharge, diagnoses and previous hospitalization, pre-admission IADL was an independent risk factor for 2-3 month readmission.

Risk factors for hospital readmission of elderly patients

“…Vascular diseases and particularly heart failure at discharge were associated to readmission, in agreement with previous observations on the predictive role of diseases of the circulatory system [12] and particularly of heart failure [25]. Also liver diseases were associated with readmission, in agreement with a previous study based upon 30-day readmission [7].…”

“…These findings are broadly consistent with other observations, showing that previous hospital admission, morbidity/comorbidity and also functional disability and length of hospital stay were common risk factors in people aged ≥ 75 years [9]. In some studies, the duration of hospital stay (defined as longer than the 90th percentile of hospital stays or than median or than 3 days) was associated with a higher risk of short term readmission [12,[19][20][21], most likely indicative of the severity of the basic illness. In the present study the duration of hospitalization did not affect the rate of readmission.…”

“…In this study the rate of hospital readmission within 3 months from discharge (19%) was slightly lower than the results of a previous study conducted in elderly patients (23%) [12], and than those of the study of Jencks et al (34%) conducted in patients not selected for age in the frame of Medicare [3]. Our rate is almost equal to that of Maurer et al (20%), who performed a pilot study in patients recruited by internal medicine wards in Switzerland [6].…”

“…The effect of the most common diseases at discharge on readmission was also analyzed. A long length of hospital stay was defined as a stay longer than the 90th percentile of the distribution of all patients' hospital stays [12]. To study the association between AEs and readmission, the diagnoses were grouped according to the chapters of International Classification of Disease, Ninth Revision (ICD-9).…”

Survival in the community of the very old depressed, discharged from medical inpatient care

“…European studies have indicated that approximately 11% of patients may be re-admitted within a month of discharge (Comette et al, 2005). Such patients were excluded from this study.…”