Key result
History of falls linked to ~4-fold higher 30-day readmission risk in patients over 80.
Why the study?
Thirty-day hospital readmission rates rise significantly with advanced age, but the performance of existing predictive models remains uncertain in the oldest population.
Do multimorbidity, history of falls, and frailty increase the risk of 30-day hospital readmission in patients aged 80 and older?
Cohort
No
Do multimorbidity, history of falls, and frailty increase the risk of 30-day hospital readmission in patients aged 80 and older?
Effect estimate: OR ~4
In patients aged 80 and older, multimorbidity, severe frailty, and a history of falls within 12 months are significant predictors of 30-day hospital readmission.
BACKGROUND/PURPOSE: Thirty-day hospital readmission rate significantly raised with advanced age. The performance of existing predictive models for readmission risk remained uncertain in the oldest population. We aimed to examine the effect of geriatric conditions and multimorbidity on readmission risk among older adults aged 80 and over. METHODS: This prospective cohort study enrolled patients aged 80 and older discharged from a geriatric ward at a tertiary hospital, with phone follow-up for 12 months. Demographics, multimorbidity, and geriatric conditions were assessed before hospital discharge. Logistic regression models were conducted to analyse risk factors for 30-day readmission. RESULTS: Patients readmitted had higher Charlson comorbidity index scores, and were more likely to have falls, frailty, and longer hospital stay, compared to those without 30-day readmission. Multivariate analysis revealed that higher Charlson comorbidity index score was associated with readmission risk. Older patients with a fall history within 12 months had a near 4-fold increase in readmission risk. Severe frailty status before index admission was associated with a higher 30-day readmission risk. Functional status at discharge was not associated with readmission risk. CONCLUSION: In addition to multimorbidity, history of falls and frailty were associated with higher hospital readmission risk in the oldest.
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Tsai et al. (2023) conducted a cohort in Hospital readmission risk. Multimorbidity, prior falls, and frailty vs. Absence of these risk factors was evaluated on 30-day hospital readmission (OR ~4). A history of falls within 12 months was associated with a near 4-fold increase in 30-day hospital readmission risk among patients aged 80 and older, alongside multimorbidity and severe frailty.
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