Predictors of rehospitalization among elderly patients admitted to a rehabilitation hospital: the role of polypharmacy, functional status, and length of stay.
Predictors of rehospitalization among elderly patients admitted to a rehabilitation hospital: the role of polypharmacy, functional status, and length of stay.
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DOI：
10.1016/j.jamda.2013.03.013
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发表时间：
2013-10
影响因子：
7.6
通讯作者：
Trabucchi M
中科院分区：
文献类型：
--
作者：
Morandi A;Bellelli G;Vasilevskis EE;Turco R;Guerini F;Torpilliesi T;Speciale S;Emiliani V;Gentile S;Schnelle J;Trabucchi M
老年患者的再住院是日益增加的卫生保健负担。尽管如此，我们对急性住院后入住院内康复机构的老年患者的计划外再住院和相关风险因素的信息有限。院内康复和老年护理病房回顾性队列研究2004年1月至2011年6月期间，因急性住院而入住院内康复医院的≥65岁老年患者。记录30天计划外再住院率。在康复入院时评估计划外再住院的风险因素：年龄、合并症、血清白蛋白、药物数量、功能状态下降、谵妄、简易精神状态检查评分、急性住院时间。使用多变量考克斯比例回归模型确定上述风险因素对30天随访内至事件发生时间的影响。2，735名患者的中位年龄为80岁（四分位距74-85），其中98名（4%）在30天内再次住院。30天计划外再住院的独立预测因素是使用7种或更多药物（风险比[HR]，3.94; 95%置信区间，1.62-9.54; P=.002）和功能状态显著下降（Barthel指数≥ 56分）与入院前一个月相比（HR 2.67，95% CI：1.35-5.27; P=.005）。此外，急性住院时间≥13天的再住院风险增加2倍（HR 2.67，95% CI：1.39-5.10; P=.003）。本研究中计划外再住院率较低。多种药物治疗、与急性入院前一个月相比功能状态显著恶化和住院时间是重要的风险因素。
Rehospitalizations for elderly patients are an increasing health care burden. Nonetheless, we have limited information on unplanned rehospitalizations and the related risk factors in elderly patients admitted to in-hospital rehabilitation facilities after an acute hospitalization. In-hospital Rehabilitation and Aged Care Unit Retrospective cohort study Elderly patients ≥65 years admitted to an in-hospital rehabilitation hospital after an acute hospitalization between January 2004 and June 2011. The rate of 30-day unplanned rehospitalization to hospitals was recorded. Risk factors for unplanned rehospitalization were evaluated at rehabilitation admission: age, comorbidity, serum albumin, number of drugs, decline in functional status, delirium, Mini Mental State Examination score, length of stay in the acute hospital. A multivariable Cox proportional regression model was used to identify the effect of the above-mentioned risk factors for time to event within the 30-day follow-up. Among 2,735 patients, with a median age of 80 years (Interquartile Range 74–85), 98 (4%) were rehospitalized within 30 days. Independent predictors of 30-day unplanned rehospitalization were the use of 7 or more drugs (Hazard Ratio [HR], 3.94; 95% Confidence Interval, 1.62–9.54; P=.002) and a significant decline in functional status (56 points or more at the Barthel Index) compared to the month prior to hospital admission (HR 2.67, 95% CI: 1.35–5.27; P=.005). Additionally, a length of stay in the acute hospital ≥13 days carried a 2 fold higher risk of rehospitalization (HR 2.67, 95% CI: 1.39–5.10); P=.003). The rate of unplanned rehospitalization was low in this study. Polypharmacy, a significant worsening of functional status compared to the month prior to acute hospital admission and hospital length of stay are important risk factors.
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影响因子：
2.8
作者：
Corsonello A;Pedone C;Corica F;Incalzi RA
通讯作者：
Incalzi RA
影响因子：
4.4
作者：
Giuliano, Christopher;Wilhelm, Sheila M.;Kale-Pradhan, Pramodini B.
通讯作者：
Kale-Pradhan, Pramodini B.
影响因子：
4
作者：
Bellelli, G.;Noale, M.;Trabucchi, M.
通讯作者：
Trabucchi, M.
影响因子：
7.2
作者：
HANLON, JT;SCHMADER, KE;FEUSSNER, JR
通讯作者：
FEUSSNER, JR
影响因子：
--
作者：
Lau, DT;Kasper, JD;Bennett, RG
通讯作者：
Bennett, RG