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Dementia increases risk of hospital readmission in elderly adults

09 Jun 2018

Dementia appears to drive hospital readmission among elderly adults, with its effect varying according to the primary diagnosis, according to a recent study.

Researchers performed a retrospective cohort study on 1,834,378 elderly adults (aged 65 years; 41.3 percent female) discharged from acute care hospitals. The study primary outcome was unplanned hospital readmission within 30 days. Poisson generalized estimating equation models were used to determine the risk of readmission in participants with and without dementia.

A total of 269,951 participants (14.7 percent) had dementia. The prevalence rate was lowest in those with prostate cancer (3.0 percent) and highest in those with aspiration pneumonia (69.4 percent).

The risk of hospital admission was significantly higher in patients with vs without dementia (8.3 percent vs 4.1 percent; adjusted risk ratio [RR], 1.46; 95 percent CI, 1.44–1.49). The relationship between dementia and hospital readmission varied according to primary diagnosis.

For instance, dementia significantly raised the risk of readmission in patients with hip fracture (11.5 percent vs 7.9 percent; adjusted RR, 1.46; 1.28–1.68), but this relationship was attenuated for those with cholecystitis (12.8 percent vs 12.4 percent; adjusted RR, 1.03; 0.90–1.18).

A similar trend was observed between dementia and the risk of emergency readmissions (3.9 percent vs 1.5 percent; adjusted RR, 1.64; 1.59–1.68).

“Healthcare providers could enforce interventions to minimize readmission by focusing on comorbid conditions in individuals with dementia and specific primary diagnoses that increase their risk of readmission,” said researchers.

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