Key result
Depressive symptoms at admission were not significantly associated with unplanned 30-day hospital readmission in older adults (RR 1.20; 95% CI 0.83-1.72).
Why the study?
Do depressive symptoms at admission increase the risk of unplanned 30-day hospital readmission in hospitalized adults aged 65 and older?
Cohort (n=750)
No
Do depressive symptoms at admission increase the risk of unplanned 30-day hospital readmission in hospitalized adults aged 65 and older?
Relative Risk: 1.2 (95% CI 0.83–1.72)
In hospitalized older adults, depressive symptoms at admission were not significantly associated with 30-day unplanned hospital readmission, whereas age, comorbidity burden, and recent hospitalizations were significant predictors.
Depressive symptoms should not guide readmission prevention in older adults; leaves open whether mental health assessment adds value beyond age and comorbidity.
OBJECTIVES: To quantify the risk of 30-day unplanned hospital readmission in adults aged 65 and older with depressive symptoms. DESIGN: Prospective cohort study. SETTING: University of Maryland Medical Center. PARTICIPANTS: Individuals aged 65 and older admitted between July 1, 2011, and August 9, 2012, to the general medical and surgical units and followed for 31 days after hospital discharge (N = 750). MEASUREMENTS: Primary exposure was depressive symptoms at admission, defined as a score of 6 or more on the 15-item Geriatric Depression Scale. Primary outcome was unplanned 30-day hospital readmission, defined as an unscheduled overnight stay at any inpatient facility not occurring in the emergency department. RESULTS: Prevalence of depressive symptoms was 19% and incidence of 30-day unplanned hospital readmission was 19%. Depressive symptoms were not significantly associated with hospital readmission (relative risk (RR) = 1.20, 95% confidence interval (CI) = 0.83-1.72). Age, Charlson Comorbidity Index score, and number of hospitalizations within the past 6 months were significant predictors of unplanned 30-day hospital readmission. CONCLUSION: Although not associated with hospital readmission, depressive symptoms were associated with other poor outcomes and may be underdiagnosed in hospitalized older adults. Hospitals interested in reducing readmission should focus on older adults with more comorbid illness and recent hospitalizations.
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Albrecht et al. (2014) conducted a cohort in hospitalized older adults (n=750). Depressive symptoms vs. No depressive symptoms was evaluated on unplanned 30-day hospital readmission (RR 1.20, 95% CI 0.83-1.72). Depressive symptoms at admission were not significantly associated with unplanned 30-day hospital readmission in older adults (RR 1.20; 95% CI 0.83-1.72).
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