Risk factors for hospital readmission of elderly patients

被引:72
作者
Franchi, Carlotta [1 ]
Nobili, Alessandro
Mari, Daniela [2 ]
Tettamanti, Mauro
Djade, Codjo D.
Pasina, Luca
Salerno, Francesco [3 ]
Corrao, Salvatore [4 ]
Marengoni, Alessandra [5 ]
Iorio, Alfonso [6 ]
Marcucci, Maura [6 ]
Mannucci, Pier Mannuccio [7 ]
机构
[1] Mario Negri Inst Pharmacol Res, Lab Qual Assessment Geriatr Therapies & Serv, I-20156 Milan, Italy
[2] IRCCS Maggiore Hosp Fdn, Dipartimento Sci Clin & Comunita, Milan, Italy
[3] Univ Milan, Policlin IRCCS San Donato, I-20122 Milan, Italy
[4] Univ Palermo, Dipartimento Biomed Med Interna & Specialist, I-90133 Palermo, Italy
[5] Univ Brescia, Spedali Civili, Dept Med & Surg Sci, Geriatr Unit, I-25121 Brescia, Italy
[6] Univ Perugia, Dept Internal Med, I-06100 Perugia, Italy
[7] IRCCS Maggiore Hosp Fdn, Sci Direct, Milan, Italy
关键词
Hospital readmission; Internal medicine and geriatric wards; Risk factors; Elderly; VALIDATION; WARDS;
D O I
10.1016/j.ejim.2012.10.005
中图分类号
R5 [内科学];
学科分类号
100201 [内科学];
摘要
Background: 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. Methods: 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. Results: 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. Conclusions: 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. (C) 2012 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
引用
收藏
页码:45 / 51
页数:7
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