The survival and characteristics of older people with and without dementia who are hospitalised following intentional self-harm

Mitchell, Robert J.; Draper, Brian; Harvey, Lara; Brodaty, Henry; Close, Jacqueline C.T.

doi:10.1002/gps.4542

Cited by 14 publications

(36 citation statements)

References 24 publications

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“…Eleven studies had a small sample size (range: 42‐395), were conducted in a single hospital (‐ward), or showed a sex distribution not representative of the PWD population . Thirty‐three studies met the criteria for comparability based on design or analysis, thereof 8 studies controlled or matched for 1 factor and 25 studies for at least 2 factors . Fourteen studies reported multivariate and descriptive results for LOS, and 5 studies solely multivariate results .…”

Section: Resultsmentioning

confidence: 99%

Length of hospital stay and dementia: A systematic review of observational studies

Möllers

Stocker

Wei

et al. 2018

Int J Geriat Psychiatry

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Objective Hospitalizations of people with dementia (PWD) are often accompanied by complications or functional loss and can lead to adverse outcomes. Unsystematic findings suggest an influence of comorbidities on the extent of differences in the length of hospital stay (LOS). This systematic review aimed to identify and evaluate all studies reporting LOS in PWD as compared to PwoD in general hospitals. Methods A systematic review of observational studies using PubMed and ISI Web of Knowledge. Inclusion criteria comprised original studies written in English or German, assessment of diagnosis of dementia, measurement of LOS, and comparison of people with and without dementia. Results Fifty‐two of 60 studies reported a longer hospitalization time for PWD compared to PwoD. The extent of the difference in LOS varied between and within countries as well as by type of primary morbidity (eg, injuries, cardiovascular diseases). The range of the LOS difference for studies without restriction to a primary morbidity was −2 to +22 days after matching or adjustment for a variable number and selection of potentially relevant covariates. For studies with injuries/fractures/medical procedures and infectious/vascular disease as the primary morbidity, the range was −2.9 to +12.4 and −11.2 to +21.8 days, respectively. Conclusions The majority of studies reported a longer hospitalization of PWD compared to PwoD. Length of hospital stay seems to be influenced by a variety of medical, social, organizational factors, including reasons for hospital admission, whose role should be explored in detail in further research.

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Section: Resultsmentioning

confidence: 99%

Length of hospital stay and dementia: A systematic review of observational studies

Möllers

Stocker

Wei

et al. 2018

Int J Geriat Psychiatry

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“…The reported rates of all-cause 30-day readmission ranged from 7% 17 to 35%. 8,9,18,23,30,31 However, when comparing readmission rates between persons with dementia and persons with depression, no differences in readmission rates were found. 30 Two research teams studied condition-specific readmissions, including drug-related readmissions 26 and psychiatric readmissions.…”

Section: Readmission Ratementioning

confidence: 94%

“…17.8 and 18.9% in the United States,8,18 to 23.6% in Australia 31. This finding implies the influence of health care system and societal differences on patient outcomes, including readmission.Interestingly, none of the reviewed studies examined readmission rates based on where patients were readmitted from (eg, nursing home, home care agency, and home).…”

mentioning

confidence: 89%

“…One checklist is for evaluating observational cohort and cross-sectional studies, 14 32 Sixteen studies were observational, that is, one longitudinal, 20 four prospective, 9,21,24,28 and 11 retrospective. 17,27 Studies were conducted at different levels in terms of sample scales, including three national-level, 22,24,25 four state or regional, 8,18,30,31 four multisite, 16,17,19,26 and eight single-site studies. 17,27 Studies were conducted at different levels in terms of sample scales, including three national-level, 22,24,25 four state or regional, 8,18,30,31 four multisite, 16,17,19,26 and eight single-site studies.…”

Section: Quality Appraisal Of Reviewed Studiesmentioning

confidence: 99%

“…8,16,18,19,22,23,25,[29][30][31][32] Three were intervention studies, that is, one randomized controlled trial (RCT) 26 and two quasiexperimental studies. 9,20,21,23,[27][28][29]32 Various data sources were used, including patient medical records (n = 12, 67%), 9,16,17,[19][20][21]23,[26][27][28][29]31,32 billing and/or claims files (n = 6, 33%), 8,16,18,20,22,25 registry data (n = 5, 28%), 9,16,24,30,31 and surveys and/or interviews (n = 9, 50%). 9,20,21,23,[27][28]…”

Section: Quality Appraisal Of Reviewed Studiesmentioning

confidence: 99%

See 2 more Smart Citations

Hospital readmission in persons with dementia: A systematic review

Bao

Dull

et al. 2019

Int J Geriat Psychiatry

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Objective Hospital readmission in persons with dementia is becoming a critical safety and cost issue. The purpose of this review is to systematically assess published evidence on hospital readmissions in persons with dementia, including rate, clinical reasons, risk factors, and prevention programs. Methods A systematic review of relevant literature was conducted. Literature were searched in PubMed, CINAHL, PsycINFO, and Embase as well as hand searching. Quality of reviewed studies were assessed independently by reviewers using quality assessment checklists. Results Nineteen studies met the inclusion criteria and were reviewed. In persons with dementia, all‐cause 30‐day readmission rate was most frequently reported and ranged from 7% to 35%. Compared with those without dementia, persons with dementia had significantly higher rate of readmission. Reported risk factors of readmission varied across studies from patient sociodemographic and clinical status, history of health care utilization, to family caregivers. Reasons for readmission were rarely documented. Programs of home‐based individualized care and interdisciplinary team care were used for preventing readmissions. Findings from some of the studies were limited by small sample sizes, single data source, and other methodologic flaws. Conclusions Persons with dementia are at high risk for hospital readmission, but many of the readmissions are potentially preventable. Multiple strategies such like identifying high‐risk individuals and the clinical reasons for index admission and readmission and implementing home‐based individualized care by interdisciplinary team can reduce preventable hospital readmissions. Future studies should use multiple national data sources and advanced methodology to identify risk factors and clinical reasons of hospital readmissions.

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Risk factors for dementia and self‐harm: A linkage study

Walker

Srasuebkul

Trollor

et al. 2023

Alzheimer's & Dementia

Self Cite

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IntroductionPeople living with dementia experience poor mental health and high rates of self‐harm. We investigated risk factors for self‐harm in people aged > 40 years living with dementia and risk factors for dementia after self‐harm.MethodsUsing linked hospital data from New South Wales, Australia, we defined a dementia cohort (n = 154,811) and a self‐harm cohort (n = 28,972). Using survival analyses, we investigated predictors of self‐harm for the dementia cohort, and predictors of dementia for the self‐harm cohort.ResultsWe found self‐harm or dementia diagnoses occurred most often within 24 months of a dementia diagnosis or initial self‐harm presentation, respectively. Men living with dementia, and people with complex psychiatric profiles, had the greatest risk of self‐harm. Men who had self‐harmed had the greatest risk of dementia diagnoses.DiscussionMen and people with complex psychiatric profiles and dementia may particularly benefit from post‐diagnosis mental and behavioral support to reduce risk of self‐harm.

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The survival and characteristics of older people with and without dementia who are hospitalised following intentional self-harm

Cited by 14 publications

References 24 publications

Length of hospital stay and dementia: A systematic review of observational studies

Length of hospital stay and dementia: A systematic review of observational studies

Hospital readmission in persons with dementia: A systematic review

Risk factors for dementia and self‐harm: A linkage study

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