• J Am Med Dir Assoc · Mar 2009

    Relationship between two-year mortality and 30 day to the Hospital Readmission from the Nursing Home.

    • Syed W Hussain, Stephen S Cha, and Paul Y Takahashi.
    • Division of Primary Care Medicine.
    • J Am Med Dir Assoc. 2009 Mar 1; 10 (3): B14.

    Introduction/ObjectiveHospital readmission from the nursing home is often a concerning development for nursing home residents who have recently been dismissed from the hospital. Clinicians and family often consider the potential prognosis when residents return to the hospital. The objective was to determine the relationship between two-year mortality and 30-day hospital readmission status from the nursing home.Design/MethodologyThis was a retrospective cohort study of all adult patients over 60 living within the nursing home in Olmsted County , MN. All residents were impaneled within a primary care practice. Of this initial nursing home cohort, the residents was then divided into those residents who were readmitted to the hospital within 30 days and those who were not readmitted. The primary outcome was mortality within 2 years of 1/1/05. Data analysis involved Pearson's chi square analysis for the proportional variables.ResultsThere were 12,650 patients within the initial panel of which 2261 were admitted to the nursing home. Of this 2261 cohort, 347 residents (15.3%) were readmitted to the hospital within 30 days. Of the 347 readmitted, 106 residents died within 2 years (31%) versus 293 (15%) in the group that was not readmitted to the hospital (p <0.001) with a hazard ratio of 2.43 [95% CI 1.88-3.16].Conclusion/DiscussionOlder adults who are admitted to the nursing home are at significant risk of 2-year mortality with 2.5 times the odds of mortality in 2 years compared to those residents who are not readmitted. Those patients who are readmitted are older which could explain some of this difference or they could have significant comorbid illness which explains the higher mortality. When faced with residents who have multiple hospital admissions, the provider should consider potential discussion of end of life issues and advanced directives given the prognosis.

      Pubmed     Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…