Key result
Geriatric syndromes assessed at admission, such as fall events (OR 4.36), urinary incontinence (OR 4.21), and depressive mood (OR 3.88), were significantly associated with an increased risk of 1-year hospital readmission in older adults.
Why the study?
Given the association between geriatric syndrome and hospital readmission, the authors evaluated geriatric syndrome screening for care (GSC) for identifying readmission risk and determining the appropriate screening time.
Does geriatric syndrome screening within 48 hours of admission predict 1-year readmission in general ward inpatients aged 65 years or older?
Cohort (n=2,663)
No
Does geriatric syndrome screening within 48 hours of admission predict 1-year readmission in general ward inpatients aged 65 years or older?
Odds Ratio: 4.36 (95% CI 2.36–8.05)
p-value: p=<0.001
Geriatric syndrome screening within 48 hours of admission, particularly identifying fall events, urinary incontinence, and depressive mood, is associated with an increased risk of 1-year hospital readmission in older adults.
May flag older adults at high readmission risk; leaves open whether interventions reduce events.
BACKGROUND: Given the association between geriatric syndrome and hospital readmission, we evaluated the suitability of geriatric syndrome screening for care (GSC) in identifying readmission risk and suggested the appropriate time for GSC. METHODS: GSC considering cognitive impairment, depression, polypharmacy (five or more medications), functional mobility, dysphagia, malnutrition, pain, and incontinence was performed among 2,663 general ward inpatients aged 65 years or older within 48 hours after admission and again before discharge between November 2016 and October 2017. From each patient, fall events, pressure ulcers, potentially inappropriate medication use, and delirium were assessed at admission. Patients were divided into two groups on the basis of readmission within 1 year after the first admission. According to the screening period (at admission and before discharge) and in-hospital decline, we applied receiver operating characteristic curve analysis to compare the prevalence of clinical concerns between the readmission and no-readmission groups. We also used multiple logistic regression analysis to evaluate the risk of readmission according to the presence of geriatric syndrome and clinical outcomes. RESULTS: The 782 readmitted patients (29.4%) showed a higher rate of poor GSC than those who were not readmitted. Polypharmacy at admission was significantly correlated with readmission risk (area under the receiver operating characteristic curve=0.602). Fall events (odds ratio [OR]=4.36; 95% confidence interval [CI], 2.36-8.05), urinary incontinence (OR=4.21; 95% CI, 3.28-5.39), and depressive mood (OR=3.88; 95% CI, 2.69-5.59) at admission were risk factors for readmission. CONCLUSION: Geriatric syndromes assessed by GSC at admission was associated with an increased risk of readmission.
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Shin et al. (2020) conducted a cohort in General ward inpatients (n=2,663). Geriatric syndromes at admission (e.g., fall events) vs. Absence of geriatric syndromes was evaluated on Readmission within 1 year (OR 4.36, 95% CI 2.36-8.05, p=<0.001). Geriatric syndromes assessed at admission, such as fall events (OR 4.36), urinary incontinence (OR 4.21), and depressive mood (OR 3.88), were significantly associated with an increased risk of 1-year hospital readmission in older adults.
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