دورية أكاديمية
Understanding 30-day re-admission after hospitalisation of older patients for diabetes: identifying those at greatest risk.
| العنوان: | Understanding 30-day re-admission after hospitalisation of older patients for diabetes: identifying those at greatest risk. |
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| المؤلفون: | Caughey GE; Quality Use of Medicines and Pharmacy Research Centre, University of South Australia, Adelaide, SA gillian.caughey@unisa.edu.au., Pratt NL; Quality Use of Medicines and Pharmacy Research Centre, University of South Australia, Adelaide, SA., Barratt JD; Quality Use of Medicines and Pharmacy Research Centre, University of South Australia, Adelaide, SA., Shakib S; Royal Adelaide Hospital, Adelaide, SA., Kemp-Casey AR; Quality Use of Medicines and Pharmacy Research Centre, University of South Australia, Adelaide, SA., Roughead EE; University of South Australia, Adelaide, SA. |
| المصدر: | The Medical journal of Australia [Med J Aust] 2017 Mar 06; Vol. 206 (4), pp. 170-175. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Australasian Medical Publishing Co Country of Publication: Australia NLM ID: 0400714 Publication Model: Print Cited Medium: Internet ISSN: 1326-5377 (Electronic) Linking ISSN: 0025729X NLM ISO Abbreviation: Med J Aust Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: Original Publication: Sydney : Australasian Medical Pub. Co. |
| مواضيع طبية MeSH: | Diabetes Mellitus, Type 2/*epidemiology , Diabetes Mellitus, Type 2/*therapy , Hospitalization/*statistics & numerical data , Patient Readmission/*statistics & numerical data, Age Factors ; Aged ; Aged, 80 and over ; Australia ; Cohort Studies ; Comorbidity ; Female ; Heart Failure/epidemiology ; Heart Failure/therapy ; Humans ; Male ; Patient Discharge/statistics & numerical data ; Retrospective Studies ; Risk Factors |
| مستخلص: | Objective: To identify factors that contribute to older Australians admitted to hospital with diabetes being re-hospitalised within 30 days of discharge. Design, Setting and Participants: A retrospective cohort study of Department of Veterans' Affairs administrative data for all patients hospitalised for diabetes and discharged alive during the period 1 January - 31 December 2012. Main Outcome Measures: Causes of re-hospitalisation and prevalence of clinical factors associated with re-hospitalisation within 30 days of discharge. Methods: Multivariate logistic regression analysis (backward stepwise) was used to identify characteristics predictive of 30-day re-hospitalisation. Results: 848 people were hospitalised for diabetes; their median age was 87 years (interquartile range, 77-89 years) and 60% were men. 209 patients (24.6%) were re-hospitalised within 30 days of discharge, of whom 77.5% were re-admitted within 14 days of discharge. 51 re-hospitalisations (24%) were for diabetes-related conditions; 41% of those re-admitted within 14 days had not seen their general practitioner between discharge and re-admission. Factors predictive of re-hospitalisation included comorbid heart failure (adjusted odds ratio [aOR], 1.49; 95% confidence interval [CI], 1.03-2.17; P = 0.036), numbers of prescribers in previous year (aOR [for each additional prescriber], 1.06; 95% CI, 1.01-1.08; P = 0.031), and two or more hospitalisations in the 6 months before the index admission (aOR, 1.79; 95% CI 1.15-2.78; P = 0.009). Conclusion: Older people hospitalised for diabetes who have comorbid heart failure, multiple recent hospitalisations, and multiple prescribers involved in their care are at greatest risk of being re-admitted to hospital within 30 days. Targeted follow-up during the initial 14 days after discharge may facilitate appropriate interventions that avert re-admission of these at-risk patients. |
| تواريخ الأحداث: | Date Created: 20170303 Date Completed: 20170329 Latest Revision: 20220321 |
| رمز التحديث: | 20240628 |
| DOI: | 10.5694/mja16.00671 |
| PMID: | 28253467 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 1326-5377 |
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| DOI: | 10.5694/mja16.00671 |