Frailty is associated with hospital readmission in geriatric patients: a prognostic study
- PDF / 688,018 Bytes
- 10 Pages / 595.276 x 790.866 pts Page_size
- 6 Downloads / 202 Views
RESEARCH PAPER
Frailty is associated with hospital readmission in geriatric patients: a prognostic study Merete Gregersen1 · Troels K. Hansen1 · Bodil B. Jørgensen1 · Else Marie Damsgaard1 Received: 4 March 2020 / Accepted: 14 May 2020 © European Geriatric Medicine Society 2020
Key summary points Aim To examine the predictive value of the Multidimensional Prognostic Index (MPI) on unplanned hospital readmission in geriatric patients. Findings Frail patients have higher risk of unplanned readmission compared to non-frail. Message The aggregated MPI is superior to the prognostic value of every single domain in the tool according to the prediction of unplanned readmission. Abstract Purpose Targeting health care interventions requires valid measurements when predicting unplanned hospital readmission. The Multidimensional Prognostic Index (MPI) based on Comprehensive Geriatric Assessment (CGA) enables the prediction of mortality and length of stay (LOS) in older hospitalized patients. Our aim was to validate if the MPI as a frailty tool could predict unplanned hospital readmission in geriatric patients. Methods This prognostic study was conducted in geriatric wards. The target population was 65 + -year-old patients hospitalized with acute illness. The MPI tool is derived from eight CGA domains by an interdisciplinary team: social aspects, number of drugs, activities of daily living (ADL), instrumental-ADL, cognitive status, severity of morbidity, risk of developing pressure sores, and nutritional status. Patients assessed were categorized into three groups: non-frail (MPI-1), moderate frail (MPI-2) or severe frail (MPI-3). Primary outcome was 30-day unplanned readmission and secondary LOS and 90-day mortality. Results In total 1467 patients were included from January 1, 2018, to October 1, 2019. Mean age was 84.2 years (± 7.4) and 59% were women. 15.7% were readmitted. Hazard ratio (HR) for readmission in the MPI-2 group (n = 635) was 2.57; 95% confidence interval (CI) 1.25–5.29 (p = 0.01), and 2.60; 95% CI 1.27–5.33 (p = 0.009) in the MPI-3 group (n = 711) compared to the MPI-1 group (n = 121). MPI was a predictor of LOS and mortality. Conclusion Using the MPI tool to identify the frail and non-frail patients is applicable to predict unplanned hospital readmission in geriatric patients. The MPI is superior to the prognostic value of each single domain. MPI will be of great value to health professionals’ decision-making.
Background
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s41999-020-00335-w) contains supplementary material, which is available to authorized users. * Merete Gregersen [email protected] 1
Department of Geriatrics, Aarhus University Hospital, Palle Juul‑Jensens Boulevard 99, Building, 8200 Aarhus N, Denmark
“Frailty is a disorder of several inter-related physiological systems” [1]. In older persons, frailty increases the risk of hospitalization as well as fall, functional impairment, delirium, institutionalization, and death [1–4]. Also,
Data Loading...
