Key result
Depressive symptoms in older medical inpatients were independently associated with an increased likelihood of inpatient death and transfer for rehabilitation, but not longer length of stay.
Why the study?
Do depressive symptoms predict adverse hospital outcomes in older medical inpatients?
Cohort (n=617)
No
Do depressive symptoms predict adverse hospital outcomes in older medical inpatients?
Depressive symptoms in older medical inpatients are an independent predictor of inpatient mortality and the need for post-discharge rehabilitation.
May prompt closer monitoring in older inpatients with depressive symptoms; leaves open whether interventions improve outcomes.
OBJECTIVE: to examine the relationship between depressive symptoms and hospital outcomes in an unselected consecutive sample of older medical inpatients. DESIGN: a prospective cohort study of individuals screened for a trial. SETTING: medical wards of UK district general hospital in rural East Anglia. PARTICIPANTS: six hundred and seventeen medical inpatients aged 65+ were randomly selected from consecutive admissions. Baseline measures: 15-item Geriatric Depression Scale (GDS-15), the Abbreviated Mental Test Score (AMTS) and the Cumulative Illness Rating Scale-Geriatric (CIRS-G). MAIN OUTCOME MEASURES: length of hospital stay; discharge to a community hospital (for rehabilitation), institutional care or usual place of residence; dying in hospital. RESULTS: depressive symptoms are independently associated with an increased likelihood of inpatient death and transfer to a community hospital for rehabilitation, but are not associated with longer length of stay. CONCLUSIONS: research evaluating effectiveness of identification and treatment of depression in older medical inpatients should consider including inpatient death and use of rehabilitation services as potential outcomes.
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Cullum et al. (2008) conducted a cohort in older medical inpatients (n=617). depressive symptoms vs. absence of depressive symptoms was evaluated on length of hospital stay; discharge to a community hospital, institutional care or usual place of residence; dying in hospital. Depressive symptoms in older medical inpatients were independently associated with an increased likelihood of inpatient death and transfer for rehabilitation, but not longer length of stay.
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