Depressive symptoms and hospital readmission in older adults.
Depressive symptoms and hospital readmission in older adults.
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DOI：
10.1111/jgs.12686
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发表时间：
2014-03
影响因子：
6.3
通讯作者：
Furuno JP
中科院分区：
文献类型：
--
作者：
Albrecht JS;Gruber-Baldini AL;Hirshon JM;Brown CH;Goldberg R;Rosenberg JH;Comer AC;Furuno JP
确定再入院高风险患者可能有助于干预措施以改善护理。抑郁症状在住院的老年人中普遍存在，如果与再入院有关，则可能提供这些干预措施的目标。本研究的目的是量化年龄≥65岁有抑郁症状的成年人30天计划外再入院的风险。在2011年7月1日至2012年8月9日期间入住马里兰大学医学中心的≥65岁成人的前瞻性队列研究。750名年龄≥65岁的患者住进普通内科和外科病房，出院后随访31天。初次暴露是入院时的抑郁症状，在15项老年抑郁量表中定义为≥6。主要结局是未计划的30天再入院，定义为未计划的在非急诊科的任何住院设施过夜。抑郁症状的患病率为19%，30天计划外再入院的发生率为19%。抑郁症状与再入院无显著相关性(相对风险（RR） 1.20；95%置信区间（CI） 0.83, 1.72)。年龄、Charlson合并症指数评分和过去6个月内≥2次住院是非计划30天再入院的显著预测因素。虽然在我们的研究中，抑郁症状与再入院无关，但在住院的老年人中，抑郁症状与其他不良预后相关，可能未得到充分诊断。对减少再入院感兴趣的医院应该把重点放在有更多合并症和最近住院的老年患者身上。
Identifying patients at high risk of hospital readmission may facilitate interventions to improve care. Depressive symptoms are prevalent among hospitalized older adults and may provide a target for these interventions if associated with readmission. The aim of this study was to quantify the risk of 30-day unplanned hospital readmission among adults age ≥65 with depressive symptoms. Prospective cohort study of adults aged ≥65 admitted to the University of Maryland Medical Center between 7/1/11 and 8/9/12. 750 patients aged ≥65 admitted to the general medical and surgical units and followed for 31 days following hospital discharge. Primary exposure was depressive symptoms at admission, defined as ≥6 on the 15-item Geriatric Depression Scale. Primary outcome was unplanned 30-day hospital readmission, defined as an unscheduled overnight stay at any inpatient facility not occurring in the emergency department. Prevalence of depressive symptoms was 19% and incidence of 30-day unplanned hospital readmission was 19%. Depressive symptoms were not significantly associated with hospital readmission (Relative Risk (RR) 1.20; 95% Confidence Interval (CI) 0.83, 1.72). Age, Charlson Comorbidity Index score, and ≥2 hospitalizations within the past 6 months were significant predictors of unplanned 30-day hospital readmission. Although not associated with hospital readmission in our study, depressive symptoms are associated with other poor outcomes and may be under-diagnosed among hospitalized older adults. Hospitals interested in reducing readmission should focus on older patients with more comorbid illness and recent hospitalizations.
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影响因子：
7.2
作者：
Kossovsky, MP;Perneger, TV;Gaspoz, JM
通讯作者：
Gaspoz, JM
影响因子：
4.8
作者：
Muzzarelli, Stefano;Leibundgut, Gregor;Brunner-La Rocca, Hans-Peter
通讯作者：
Brunner-La Rocca, Hans-Peter
影响因子：
5.9
作者：
Marcantonio, ER;McKean, S;Brennan, TA
通讯作者：
Brennan, TA
影响因子：
2.1
作者：
Gorman, J.;Vellinga, A.;O'Keeffe, S. T.
通讯作者：
O'Keeffe, S. T.
影响因子：
158.5
作者：
Jencks, Stephen F.;Williams, Mark V.;Coleman, Eric A.
通讯作者：
Coleman, Eric A.