Mario Negri Institute for Pharmacological Research, Milan, Italy.
Eur J Intern Med. 2013 Jan;24(1):45-51. doi: 10.1016/j.ejim.2012.10.005. Epub 2012 Nov 8.
The aim of this study was to identify which factors were associated with a risk of hospital readmission within 3 months after discharge of a sample of elderly patients admitted to internal medicine and geriatric wards.
Of the 1178 patients aged 65 years or more and discharged from one of the 66 wards of the 'Registry Politerapie SIMI (REPOSI)' during 2010, 766 were followed up by phone interview 3 months after discharge and were included in this analysis. Univariate and multivariate logistic regression models were used to evaluate the association of several variables with rehospitalization within 3 months from discharge.
Nineteen percent of patients were readmitted at least once within 3 months after discharge. By univariate analysis in-hospital clinical adverse events (AEs), a previous hospital admission, number of diagnoses and drugs, comorbidity and severity index (according to Cumulative Illness Rating Scale-CIRS), vascular and liver diseases with a level of impairment at discharge of 3 or more at CIRS were significantly associated with risk of readmission. Multivariate logistic regression analysis showed that only AEs during hospitalization, previous hospital admission, and vascular and liver diseases were significantly associated with the likelihood of readmission.
The results demonstrate the need for increased medical attention towards elderly patients discharged from hospital with characteristics such as AEs during the hospitalization, previous admission, vascular and liver diseases.
本研究旨在确定哪些因素与老年患者内科和老年病房出院后 3 个月内再次住院的风险相关。
在 2010 年期间,从“SIMI 综合治疗登记处(REPOSI)”的 66 个病房之一出院的 1178 名 65 岁或以上的患者中,通过电话随访对 766 名患者进行了 3 个月的随访,并将其纳入本分析。使用单变量和多变量逻辑回归模型评估了几种变量与出院后 3 个月内再次住院的相关性。
19%的患者在出院后 3 个月内至少再次住院一次。通过单变量分析,住院期间的临床不良事件(AE)、既往住院、诊断和药物数量、合并症和严重程度指数(根据累积疾病评分量表-CIRS)、出院时 CIRS 为 3 或更高的血管和肝脏疾病与再次入院的风险显著相关。多变量逻辑回归分析表明,只有住院期间的 AE、既往住院和血管及肝脏疾病与再次入院的可能性显著相关。
研究结果表明,需要加强对具有住院期间 AE、既往入院、血管和肝脏疾病等特征的出院老年患者的医疗关注。