Association between hospital admission either directly or via the emergency department, and readmission rates at 30 days in older adults in two rural hospitals : a retrospective cohort study
© 2023. The Author(s), under exclusive licence to Springer Nature Switzerland AG..
INTRODUCTION: Older patients are frequently re-admitted to the hospital after attending the emergency department (ED). We investigated whether direct admission to the hospital was associated with a lower risk of readmission at 30 days compared to admission via the ED, in patients aged ≥ 75 years.
METHODS: Retrospective multicenter cohort study from 01/01/2018 to 31/12/2019, including patients aged ≥ 75 years from two hospitals. Patients admitted directly were matched 1:1 with patients admitted via the ED for center, age category, sex, major diagnosis category, type of stay (medical/surgical), and severity. We compared readmission at 30 days (primary outcome) and length of stay (secondary outcome) between groups.
RESULTS: A total of 1486 matched patients with an available outcome measure were included for analysis. We observed no significant difference in 30-day readmission rate between those admitted directly (102/778, 13.1%) and those admitted via the ED (87/708, 12.3%, p = 0.63). There was a significant difference in length of stay between both groups: median 5 days [Q1-Q3: 2-8] vs 6 days [2-11] for direct and ED admissions, respectively (effect size: 0.11, p < 0.001). By multivariate analysis, only moderate to severe denutrition was associated with the risk of readmission at 30 days (Odds Ratio 2.133, 95% Confidence Interval 1.309-3.475).
CONCLUSION: The mode of entry to the hospital of patients aged 75 years and older was not associated with the risk of readmission at 30 days. However, those admitted directly had a significantly shorter length of stay than those admitted via the ED.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:35 |
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| Enthalten in: |
Aging clinical and experimental research - 35(2023), 11 vom: 07. Nov., Seite 2703-2710 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Gaston, Michaël [VerfasserIn] |
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| Links: |
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| Themen: |
Admission |
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| Anmerkungen: |
Date Completed 08.11.2023 Date Revised 08.11.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1007/s40520-023-02543-3 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM361740654 |
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| 100 | 1 | |a Gaston, Michaël |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Association between hospital admission either directly or via the emergency department, and readmission rates at 30 days in older adults in two rural hospitals |b a retrospective cohort study |
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| 500 | |a Date Revised 08.11.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2023. The Author(s), under exclusive licence to Springer Nature Switzerland AG. | ||
| 520 | |a INTRODUCTION: Older patients are frequently re-admitted to the hospital after attending the emergency department (ED). We investigated whether direct admission to the hospital was associated with a lower risk of readmission at 30 days compared to admission via the ED, in patients aged ≥ 75 years | ||
| 520 | |a METHODS: Retrospective multicenter cohort study from 01/01/2018 to 31/12/2019, including patients aged ≥ 75 years from two hospitals. Patients admitted directly were matched 1:1 with patients admitted via the ED for center, age category, sex, major diagnosis category, type of stay (medical/surgical), and severity. We compared readmission at 30 days (primary outcome) and length of stay (secondary outcome) between groups | ||
| 520 | |a RESULTS: A total of 1486 matched patients with an available outcome measure were included for analysis. We observed no significant difference in 30-day readmission rate between those admitted directly (102/778, 13.1%) and those admitted via the ED (87/708, 12.3%, p = 0.63). There was a significant difference in length of stay between both groups: median 5 days [Q1-Q3: 2-8] vs 6 days [2-11] for direct and ED admissions, respectively (effect size: 0.11, p < 0.001). By multivariate analysis, only moderate to severe denutrition was associated with the risk of readmission at 30 days (Odds Ratio 2.133, 95% Confidence Interval 1.309-3.475) | ||
| 520 | |a CONCLUSION: The mode of entry to the hospital of patients aged 75 years and older was not associated with the risk of readmission at 30 days. However, those admitted directly had a significantly shorter length of stay than those admitted via the ED | ||
| 650 | 4 | |a Multicenter Study | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Admission | |
| 650 | 4 | |a Emergency department | |
| 650 | 4 | |a Frailty | |
| 650 | 4 | |a Geriatrics | |
| 650 | 4 | |a Malnutrition | |
| 650 | 4 | |a Readmission | |
| 700 | 1 | |a Bouazzi, Leila |e verfasserin |4 aut | |
| 700 | 1 | |a Ecarnot, Fiona |e verfasserin |4 aut | |
| 700 | 1 | |a Collard, Michèle |e verfasserin |4 aut | |
| 700 | 1 | |a Novella, Jean-Luc |e verfasserin |4 aut | |
| 700 | 1 | |a Sanchez, Stéphane |e verfasserin |4 aut | |
| 700 | 1 | |a Chrusciel, Jan |e verfasserin |4 aut | |
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