Predictors of readmission and long length of stay in elders admitted with neurological disorders in a tertiary center: a real-world investigation

Abstract

Hospital readmission and long length of stay (LOS) increase morbidity and hospital mortality and are associated with excessive costs to health systems. Objective: This study aimed to identify predictors of hospital readmission and long LOS among elders with neurological disorders (NDs). Methods: Patients ≥ 60 years of age admitted to the hospital between January 1, 2009, and December 31, 2010, with acute NDs, chronic NDs as underpinnings of acute clinical disorders, and neurological complications of other diseases were studied. We analyzed demographic factors, NDs, and comorbidities as independent predictors of readmission and long LOS (≥ 9 days). Logistic regression was performed for multivariate analysis. Results: Overall, 1,154 NDs and 2,679 comorbidities were identified among 798 inpatients aged ≥ 60 years (mean 75.8 ± 9.1). Of the patients, 54.5% were female. Patient readmissions were 251(31%) and 409 patients (51%) had an LOS ≥ 9 days (95% confidence interval 48%–55%). We found no predictors for readmission. Low socioeconomic class (p = 0.001), respiratory disorder (p < 0.001), infection (p < 0.001), genitourinary disorder (p < 0.033), and arterial hypertension (p = 0.002) were predictors of long LOS. Identified risks of long LOS explained 22% of predictors. Conclusions: Identifying risk factors for patient readmission are challenges for neurology teams and health system stakeholders. As low socioeconomic class and four comorbidities, but no NDs, were identified as predictors for long LOS, we recommend studying patient multimorbidity as well as functional and cognitive scores to determine whether they improve the risk model of long LOS in this population.

Hospitalizations in older‐adults newly diagnosed with dementia: A population‐based longitudinal study in Israel

“…The link between age and inpatient burden varied with respect to the time surrounding dementia diagnosis. Our finding that age is positively related to hospitalization burden is supported by previous findings showing that age is a risk factor for hospitalizations, both in the general population and in individuals with dementia 29 . However, we show that this positive association between age and hospitalization was apparent only in the years post dementia diagnosis.…”

Predictors of long length of hospital stay among elders admitted with seizures in a tertiary centre: a prospective study

“…We studied a population of 159 elderly inpatients with a high mean age (25% of patients were 85 years old or older). These patients had a median of five comorbidities, with a range of 4 to 7 chronic diseases; patient multimorbidity is indeed quite common among elderly inpatients 9 . We found a great number of variables associated with long LOS, not only in demographic data but also among the most frequent neurological disorders, comorbidities, and seizure disorders (Tables 1, 2, and 3).…”

“…Although especially common in the elderly, long LOS can be prevented 8 . Studies of neurological disorders among elders admitted to a tertiary centre in Salvador found epilepsy in 16% of elderly inpatients, and the majority of them had a long LOS 9,10 . Notwithstanding these facts, reports of elderly inpatients admitted with epileptic seizures in Brazil are scarce 7,11,12,13,14,15,16 .…”

The role of targeted temperature management in 30-day hospital readmissions in cardiac arrest survivors: A national population-based study

“…While prior studies have addressed neurological outcomes and mortality in patients with cardiac arrest receiving TTM within their index hospitalization, less is known about the impact of TTM regarding the rates or risk factors of readmission among survivors or the effect of TTM on various organ systems. Readmission after cardiac arrest has been associated with subpar quality of care, poor patient outcomes, and increased costs [16] , [17] . Premature or recurrent hospitalization can further impair survivors’ quality of life, recovery to baseline, and favorable neurologic evolution.…”