Kan Sheau-Wen, Yen Hsin-Yen, Chi Mei-Ju, Huang Hao-Yun
Emergency Department, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan.
School of Gerontology and Long-Term Care, College of Nursing, Taipei Medical University, 250 Wuxing St, Taipei, 11031, Taiwan.
Sci Rep. 2025 Mar 23;15(1):10003. doi: 10.1038/s41598-025-94945-8.
Unplanned readmissions are associated with increased mortality among older patients. This study investigated the effects of changes in physical function and frailty on unplanned readmissions in middle-aged and older patients after discharge.
This longitudinal study recruited participants through convenience sampling from the general wards of a medical center in northern Taiwan. They were aged 50 years or older and identified as being at high risk for readmission or mortality following discharge. Baseline data were collected through interviews conducted the day before discharged, while follow-up data were obtained through interviews at 1, 2, and 3 months post-discharge. Generalized estimating equation (GEE) was used for statistical analysis, incorporating all tracked variables, including physical function and frailty.
A total of 230 participants were recruited, each followed three times after discharge. The unplanned readmission rates at 1, 2, and 3 months post-discharge were 2%, 8%, and 14%, respectively. Participants with poorer physical function (odds ratio [OR] = 1.60 [1.27-2.02]) and more severe frailty symptoms (OR = 3.16 [1.45-6.83]) had significantly higher odds of unplanned readmission. The interaction between the time and frailty indicated a significantly lower likelihood of unplanned readmission over time (OR = 0.73 [0.54-0.98]).
Declining physical function and frailty are key risk factors for unplanned readmission in older patients. Effective strategies to reduce this risk include monitoring physical function and frailty symptoms and providing supportive care services.
非计划再入院与老年患者死亡率增加相关。本研究调查了身体功能变化和衰弱对中老年患者出院后非计划再入院的影响。
本纵向研究通过便利抽样从台湾北部一家医疗中心的普通病房招募参与者。他们年龄在50岁及以上，被确定为出院后再入院或死亡的高风险人群。基线数据通过出院前一天进行的访谈收集，而随访数据则通过出院后1、2和3个月的访谈获得。采用广义估计方程（GEE）进行统计分析，纳入所有跟踪变量，包括身体功能和衰弱情况。
共招募了230名参与者，每人出院后随访三次。出院后1、2和3个月的非计划再入院率分别为2%、8%和14%。身体功能较差（优势比[OR]=1.60[1.27 - 2.02]）和衰弱症状更严重（OR = 3.16[1.45 - 6.83]）的参与者非计划再入院的几率显著更高。时间与衰弱之间的相互作用表明，随着时间推移非计划再入院的可能性显著降低（OR = 0.73[0.54 - 0.98]）。
身体功能下降和衰弱是老年患者非计划再入院的关键危险因素。降低这种风险的有效策略包括监测身体功能和衰弱症状，并提供支持性护理服务。
