الوصف: |
Fabien Visade,1,2 Genia Babykina,1 François Puisieux,3 Frédéric Bloch,4,5 Anne Charpentier,3 Céline Delecluse,2 Gilles Loggia,6,7 Pascale Lescure,7 Jadwiga Attier-Żmudka,8,9 Cédric Gaxatte,3 Guillaume Deschasse,1,4 Jean-Baptiste Beuscart1,3 1University Lille, CHU Lille, ULR 2694 - METRICS: Évaluation des technologies de santé et des pratiques médicales, Lille, F-59000, France; 2Geriatrics Department, Lille Catholic Hospitals, Lille, F-59000, France; 3Department of Geriatrics, CHU Lille, Lille, F-59000, France; 4Department of Geriatrics, CHU Amiens-Picardie, Amiens, F-80054, France; 5Laboratory of Functional Neurosciences EA 4559, University of Picardie – Jules-Verne, Amiens, France; 6UNICAEN, INSERM, COMETE, Normandie Univ, Caen, France; 7Department of Geriatrics, Normandie Univ, UNICAEN, CHU de Caen Normandie, Caen, France; 8Geriatric Department, General Hospital of Saint-Quentin, Saint-Quentin, France; 9CHIMERE EA 7516 Head and Neck Research Group, Jules Verne University, Amiens, FranceCorrespondence: Fabien VisadeUniversity Lille, CHU Lille, ULR 2694 - METRICS: Évaluation des technologies de santé et des pratiques médicales, Lille, F-59000, FranceTel +33-320-626-969Fax +33-320-626-881Email fabien_v59@hotmail.comObjective: To analyze the impact of the number of hospital readmissions on the risks of further hospital readmission and death after adjustment for a range of risk factors.Methods: We performed a multicentre prospective study of the DAMAGE cohort in the Hauts-de-France region of France. Patients aged 75 and over hospitalized initially in an acute geriatric unit (AGU) were included and followed up for 12 months. The risk of hospital readmission was analyzed using a Cox model, and its extension for recurrent events and the risk of death were analyzed using a Cox model for time-dependent variables.Results: A total of 3081 patients were included (mean (SD) age: 86.4 (5.5)). In the multivariate analysis, the relative risk (95% confidence interval [CI]) of hospital readmission rose progressively to 2.66 (1.44; 5.14), and the risk of death rose to 2.01 (1.23; 3.32) after five hospital admissions, relative to a patient with no hospital readmissions. The number of hospital readmissions during the follow-up period was the primary risk factor and the best predictor of the risk of hospital readmission and the risk of death.Conclusion: Hospital readmission is the primary risk factor for further hospital readmissions and for death in older subjects discharged from an AGU.Keywords: hospital readmission, death, older patients, acute geriatric unit, risk factors, recurrent events |