Department of Emergency Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu, Taiwan.
Department of Geriatrics and Gerontology, National Taiwan University Hospital, Taipei, Taiwan; Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.
J Formos Med Assoc. 2023 Nov;122(11):1111-1116. doi: 10.1016/j.jfma.2023.03.009. Epub 2023 Mar 27.
BACKGROUND/PURPOSE: Thirty-day hospital readmission rate significantly raised with advanced age. The performance of existing predictive models for readmission risk remained uncertain in the oldest population. We aimed to examine the effect of geriatric conditions and multimorbidity on readmission risk among older adults aged 80 and over.
This prospective cohort study enrolled patients aged 80 and older discharged from a geriatric ward at a tertiary hospital, with phone follow-up for 12 months. Demographics, multimorbidity, and geriatric conditions were assessed before hospital discharge. Logistic regression models were conducted to analyse risk factors for 30-day readmission.
Patients readmitted had higher Charlson comorbidity index scores, and were more likely to have falls, frailty, and longer hospital stay, compared to those without 30-day readmission. Multivariate analysis revealed that higher Charlson comorbidity index score was associated with readmission risk. Older patients with a fall history within 12 months had a near 4-fold increase in readmission risk. Severe frailty status before index admission was associated with a higher 30-day readmission risk. Functional status at discharge was not associated with readmission risk.
In addition to multimorbidity, history of falls and frailty were associated with higher hospital readmission risk in the oldest.
背景/目的:随着年龄的增长,30 天内的住院再入院率显著上升。在最年长的人群中,现有的再入院风险预测模型的性能仍不确定。我们旨在研究老年病和多种合并症对 80 岁及以上老年人再入院风险的影响。
这项前瞻性队列研究纳入了从一家三级医院老年病房出院的 80 岁及以上患者,在出院后进行为期 12 个月的电话随访。在出院前评估了人口统计学、多种合并症和老年病情况。使用逻辑回归模型分析了 30 天再入院的风险因素。
与无 30 天再入院的患者相比,再入院患者的 Charlson 合并症指数评分更高,更有可能发生跌倒、衰弱和住院时间更长。多变量分析显示,Charlson 合并症指数评分越高,再入院风险越大。12 个月内有跌倒史的老年患者再入院风险增加近 4 倍。指数入院前严重衰弱状态与更高的 30 天再入院风险相关。出院时的功能状态与再入院风险无关。
除了多种合并症外,跌倒和衰弱史与最年长人群的更高住院再入院风险相关。