Dementia ups risk of readmission in elderly
In elderly adults, the risk of hospital readmission associated with dementia appears to vary with the primary diagnosis, a recent study has shown.
Researchers performed a retrospective cohort study on 1,834,378 elderly adults who were discharged after receiving care for 30 of the most common diagnoses in Japan. The overall prevalence of dementia was 14.7 percent (n=269,951) and was highest in those with aspiration pneumonia (69.4 percent).
Those with dementia had significantly higher risks of hospital readmission than those without (8.3 percent vs 4.1 percent; adjusted risk ratio [aRR], 1.46; 95 percent CI, 1.44–1.49). The relationship between the two factors varied depending on the primary diagnosis, being significant in 17 of the 30 diagnostic categories.
For instance, dementia patients with a principal diagnosis of acute myocardial infarction (aRR, 1.19; 1.01–1.39), angina pectoris (aRR, 1.22; 1.09–1.36), aspiration pneumonia (aRR, 1.23; 1.16–1.30), bowel obstruction (aRR, 1.17; 1.06–1.30) and bradyarrhythmia (aRR, 1.30; 1.12–1.51) had significantly higher risks of readmission within 30 days.
Other primary diagnoses that significantly elevated the risk of 30-day readmissions included rectal cancer (aRR, 1.27; 1.07–1.51), lung cancer (aRR, 1.15; 1.06–1.26), type 2 diabetes (aRR, 1.25; 1.09–1.44), heart failure (aRR, 1.21; 1.15–1.27) and hip fractures (aRR, 1.46; 1.28–1.68).
“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.