Mortality of older acutely admitted medical patients after early discharge from emergency departments: a nationwide cohort study [Incl. correction]

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Dokumenter

  • Martin Aasbrenn
  • Christian Fynbo Christiansen
  • Buket Öztürk Esen
  • Suetta, Charlotte
  • Finn Erland Nielsen
Background: The mortality of older patients after early discharge from hospitals is sparsely described. Information
on factors associated with mortality can help identify high-risk patients who may benefit from preventive
interventions. The aim of this study was to examine whether demographic factors, comorbidity and admission
diagnoses are predictors of 30-day mortality among acutely admitted older patients discharged within 24 h after
admission.
Methods: All medical patients aged ≥65 years admitted acutely to Danish hospitals between 1 January 2013 and
30 June 2014 surviving a hospital stay of ≤24 h were included. Demographic factors, comorbidity, discharge
diagnoses and mortality within 30 days were described using data from the Danish National Patient Registry and
the Civil Registration System. Cox regression was used to estimate adjusted hazard ratios (aHR) with 95%
confidence intervals (CI) for all-cause mortality.
Results: A total of 93,295 patients (49.4% men) with a median age of 75 years (interquartile range: 69–82 years),
were included. Out of these, 2775 patients (3.0%; 95% CI 2.9–3.1%) died within 30 days after discharge. The 30-day
mortality was increased in patients with age 76–85 years (aHR 1.59; 1.45–1.75) and 86+ years (aHR 3.35; 3.04–3.70),
male gender (aHR 1.22; 1.11–1.33), a Charlson Comorbidity Index of 1–2 (aHR 2.15; 1.92–2.40) and 3+ (aHR 4.07;
3.65–4.54), and unmarried status (aHR 1.17; 1.08–1.27). Discharge diagnoses associated with 30-day mortality were
heart failure (aHR 1.52; 1.17–1.95), respiratory failure (aHR 3.18; 2.46–4.11), dehydration (aHR 2.87; 2.51–3.29),
constipation (aHR 1.31; 1.02–1.67), anemia (aHR 1.45; 1.27–1.66), pneumonia (aHR 2.24; 1.94–2.59), urinary tract
infection (aHR 1.33; 1.14–1.55), dyspnea (aHR 1.57; 1.32–1.87) and suspicion of malignancy (aHR 2.06; 1.64–2.59).
OriginalsprogEngelsk
Artikelnummer410
TidsskriftBMC Geriatrics
Vol/bind21
Antal sider11
ISSN1471-2318
DOI
StatusUdgivet - 2021

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