Key result
Among older adults discharged from a hospital avoidance program, cumulative mortality was 24% at 1 year and 36% at 33 months, associated with lower cognition, comorbidity, and lower physical function.
Why the study?
The prevalence and predictors of mortality following discharge from a hospital avoidance program were not well characterized.
Cohort
Older adults discharged from a hospital avoidance program have high mortality rates, with specific risk factors like lower cognition and low weight identifying those who may benefit from advanced care planning.
Signals need for advanced care planning in high-risk patients; leaves open whether targeting cognition or function alters outcomes.
AIM: Following discharge from a hospital avoidance program, to examine the prevalence of patient mortality, demographic characteristics associated with risk of mortality up to 33 months, patient demographic and health characteristics associated with mortality within 1 year. METHODS: A retrospective data linkage study of older adults with mean age of 80.5 years discharged from a hospital avoidance program between January 2017 and January 2018. The prevalence of death at 3, 6, 12, 18 and 33 months was calculated. Patient demographic and health characteristics associated with participant mortality within 12 (n = 195) and 33 (n = 185) months of discharge was examined using Cox multivariable regression for patients with complete health characteristic data. RESULTS: The mortality prevalence was 17% at 6 months and cumulative prevalence at 1 year, 18 months and 33 months post-discharge were 24%, 29% and 36% respectively. Characteristics associated with mortality within 12 months of discharge were lower cognition, increased burden of comorbidity, decreased physical function, weight <55 kg and male sex. The same variables were associated with death up to 33 months as well as age, interaction between household arrangement and time, and albumin. CONCLUSIONS: The establishment of potential risk indicators allows greater specificity for identifying older people at risk of dying in the next 12 months and an opportunity to discuss their advanced care planning. Geriatr Gerontol Int 2021; ••: ••-••.
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Gul et al. (2021) conducted a cohort in Older adults referred to hospital avoidance program. Hospital avoidance program discharge was evaluated on Mortality prevalence at 3, 6, 12, 18 and 33 months. Among older adults discharged from a hospital avoidance program, cumulative mortality was 24% at 1 year and 36% at 33 months, associated with lower cognition, comorbidity, and lower physical function.
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