Predictors of rehospitalization among older adults: Results of the CRIME Study

Federica Sganga, Francesco Landi, Stefano Volpato, Antonio Cherubini, Carmelinda Ruggiero, Andrea Corsonello, Paolo Fabbietti, Fabrizia Lattanzio, Ester Manes Gravina, Roberto Bernabei, Graziano Onder

Research output: Contribution to journalArticle

Abstract

Aim: To assess the predictors of readmission among older adults hospitalized in acute care wards. Methods: A prospective cohort study was carried out among 921 hospitalized older adults participating in the CRiteria to Assess Appropriate Medication Use among Elderly Complex Patients (CRIME) project. The primary outcome of the study was rehospitalization within 1 year after discharge from acute care hospitals. We assessed the participants with a questionnaire including 350 items about demographic, social and clinical characteristics. We analyzed all factors at discharge that could be considered predictors of readmission. Results: The mean age of the participants was 81.2 years (SD 7.4 years), and 509 were women (55.3%). Overall, 280 of 921 patients (30.4%) were rehospitalized during the 1-year follow up of the study. Patients with a Mini-Mental State Examination score equal to or higher than 24 had a higher probability of rehospitalization, as compared with those who performed lower than 24 (OR 1.76, 95% CI 1.04-2.83). In addition, heart failure (OR 1.77, 95% CI 1.14-2.24), the number of falls during 1-year follow up (OR 1.15, 95% CI 1.05-1.28) and the number of drugs during first hospitalization (OR 1.15, 95% CI 1.01-1.07) were significantly associated with rehospitalization, whereas no significant association was shown for age, sex and walking speed for minimum size (OR 1.15, 95% CI 0.99-2.00). Conclusions: Predictors of readmission in older people are an intact cognitive status; the presence of a geriatric condition, such as heart failure and falls; and a high number of drugs during first hospitalization. Further studies are required to assess the impact of home care for avoiding readmission in patients with an intact cognitive status, and supporting and treating patients with dementia.

Original languageEnglish
Pages (from-to)1588-1592
Number of pages5
JournalGeriatrics and Gerontology International
DOIs
Publication statusPublished - Nov 10 2017

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hospitalization
drug
geriatrics
home care
dementia
Hospitalization
medication
Heart Failure
Patient Readmission
examination
questionnaire
Home Care Services
Geriatrics
Pharmaceutical Preparations
Dementia
Cohort Studies
Demography
Outcome Assessment (Health Care)
Prospective Studies

Keywords

  • Elderly
  • Readmission
  • Rehospitalization

ASJC Scopus subject areas

  • Health(social science)
  • Gerontology
  • Geriatrics and Gerontology

Cite this

Predictors of rehospitalization among older adults : Results of the CRIME Study. / Sganga, Federica; Landi, Francesco; Volpato, Stefano; Cherubini, Antonio; Ruggiero, Carmelinda; Corsonello, Andrea; Fabbietti, Paolo; Lattanzio, Fabrizia; Gravina, Ester Manes; Bernabei, Roberto; Onder, Graziano.

In: Geriatrics and Gerontology International, 10.11.2017, p. 1588-1592.

Research output: Contribution to journalArticle

Sganga, Federica ; Landi, Francesco ; Volpato, Stefano ; Cherubini, Antonio ; Ruggiero, Carmelinda ; Corsonello, Andrea ; Fabbietti, Paolo ; Lattanzio, Fabrizia ; Gravina, Ester Manes ; Bernabei, Roberto ; Onder, Graziano. / Predictors of rehospitalization among older adults : Results of the CRIME Study. In: Geriatrics and Gerontology International. 2017 ; pp. 1588-1592.
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abstract = "Aim: To assess the predictors of readmission among older adults hospitalized in acute care wards. Methods: A prospective cohort study was carried out among 921 hospitalized older adults participating in the CRiteria to Assess Appropriate Medication Use among Elderly Complex Patients (CRIME) project. The primary outcome of the study was rehospitalization within 1 year after discharge from acute care hospitals. We assessed the participants with a questionnaire including 350 items about demographic, social and clinical characteristics. We analyzed all factors at discharge that could be considered predictors of readmission. Results: The mean age of the participants was 81.2 years (SD 7.4 years), and 509 were women (55.3{\%}). Overall, 280 of 921 patients (30.4{\%}) were rehospitalized during the 1-year follow up of the study. Patients with a Mini-Mental State Examination score equal to or higher than 24 had a higher probability of rehospitalization, as compared with those who performed lower than 24 (OR 1.76, 95{\%} CI 1.04-2.83). In addition, heart failure (OR 1.77, 95{\%} CI 1.14-2.24), the number of falls during 1-year follow up (OR 1.15, 95{\%} CI 1.05-1.28) and the number of drugs during first hospitalization (OR 1.15, 95{\%} CI 1.01-1.07) were significantly associated with rehospitalization, whereas no significant association was shown for age, sex and walking speed for minimum size (OR 1.15, 95{\%} CI 0.99-2.00). Conclusions: Predictors of readmission in older people are an intact cognitive status; the presence of a geriatric condition, such as heart failure and falls; and a high number of drugs during first hospitalization. Further studies are required to assess the impact of home care for avoiding readmission in patients with an intact cognitive status, and supporting and treating patients with dementia.",
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AU - Landi, Francesco

AU - Volpato, Stefano

AU - Cherubini, Antonio

AU - Ruggiero, Carmelinda

AU - Corsonello, Andrea

AU - Fabbietti, Paolo

AU - Lattanzio, Fabrizia

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N2 - Aim: To assess the predictors of readmission among older adults hospitalized in acute care wards. Methods: A prospective cohort study was carried out among 921 hospitalized older adults participating in the CRiteria to Assess Appropriate Medication Use among Elderly Complex Patients (CRIME) project. The primary outcome of the study was rehospitalization within 1 year after discharge from acute care hospitals. We assessed the participants with a questionnaire including 350 items about demographic, social and clinical characteristics. We analyzed all factors at discharge that could be considered predictors of readmission. Results: The mean age of the participants was 81.2 years (SD 7.4 years), and 509 were women (55.3%). Overall, 280 of 921 patients (30.4%) were rehospitalized during the 1-year follow up of the study. Patients with a Mini-Mental State Examination score equal to or higher than 24 had a higher probability of rehospitalization, as compared with those who performed lower than 24 (OR 1.76, 95% CI 1.04-2.83). In addition, heart failure (OR 1.77, 95% CI 1.14-2.24), the number of falls during 1-year follow up (OR 1.15, 95% CI 1.05-1.28) and the number of drugs during first hospitalization (OR 1.15, 95% CI 1.01-1.07) were significantly associated with rehospitalization, whereas no significant association was shown for age, sex and walking speed for minimum size (OR 1.15, 95% CI 0.99-2.00). Conclusions: Predictors of readmission in older people are an intact cognitive status; the presence of a geriatric condition, such as heart failure and falls; and a high number of drugs during first hospitalization. Further studies are required to assess the impact of home care for avoiding readmission in patients with an intact cognitive status, and supporting and treating patients with dementia.

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