A score to predict the development of adverse clinical events after transition from acute hospital wards to post-acute care settings

Giuseppe Bellelli, Bruno Bernardini, Michela Pievani, Giovanni B. Frisoni, Antonio Guaita, Marco Trabucchi

Research output: Contribution to journalArticle

Abstract

Adverse clinical events (ACEs) are common in post-acute hospital care. We aimed at developing and validating a method, able to be administered in hospital wards, for identifying elderly patients at increased risk of ACEs after transferral to post-acute care (PAC) facilities. This was a prospective observational study, including 502 patients admitted to 19 PAC facilities in northern Italy from July 1st to August 14th, 2009. A standardized form was used to collect data. Variables showing stable association with ACEs in testing group were used to derive the score. The relative risk (RR) of developing ACEs according to the score was measured in the validation group. Age ≥87 years, delirium, pressure sore, indwelling bladder catheter, malnutrition, and acute infection on admission were identified as stable ACE predictors. A score of 1 was assigned to each predictor. Subjects were classified as having low (score=0), medium-low (score=1), medium-high (score=2-3), or high (score≥4) risk of ACEs. The RR of developing ≥1 ACE increased progressively from low (RR=1) to medium-low (RR=1.5, 95% confidence interval [CI] 1.1-1.9), medium-high (RR=1.6, 95% CI 1.3-2.1), and high (RR=1.8, 95% CI 1.4-2.3) risk score. The RR of being not discharged to home increased monotonically from 1.0 in low-risk to 2.7 in high-risk groups. In conclusion, this study proposes a method, able to be administered in hospital wards, for identifying patients at increased risk of ACEs after transferral to PAC. The score might also be used to identify people who will not return to home after PAC discharge.

Original languageEnglish
Pages (from-to)553-563
Number of pages11
JournalRejuvenation Research
Volume15
Issue number6
DOIs
Publication statusPublished - Dec 1 2012

ASJC Scopus subject areas

  • Ageing
  • Geriatrics and Gerontology

Fingerprint Dive into the research topics of 'A score to predict the development of adverse clinical events after transition from acute hospital wards to post-acute care settings'. Together they form a unique fingerprint.

  • Cite this