Factors Related to Hospital Readmission of Frail Older Adults in Korea
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Purpose: Frail older adults have a higher risk of hospital readmission due to decline in physical, functional, and psychological health status. The impact of readmission on individuals, families, or the healthcare system is tremendously devastating. This study aimed to investigate factors associated with hospital readmission of frail older adults. Materials and Methods: This was a retrospective descriptive study based on multi-professional health assessments found in elec tronic medical records of patients from a university-affiliated hospital in Seoul, Korea. The participants were 141 older adults who were admitted to the geriatric department with medical problems. Frailty, components of the comprehensive geriatric assess ment including nutrition, physical functions, psychological and cognitive status, clinical data including length of hospital stay, and readmission within 30, 90, and 180 days were collected. Survival analysis was performed, and Cox proportional hazard re gression model was used to investigate the risk factors for readmission. Results: The statistically significant variables at each time point were slightly different. However, at most time points, disease-relat ed problems (i.e., comorbidities and medications) and body functions (i.e., grip strength and physical activity) were included. The median duration until readmission was 27 days, and grip strength was found to be significantly related to readmission (p=0.020). Conclusion: After discharge, both medical services to manage the medical condition and intervention to maintain physical func tion are needed to prevent frail older adults from being readmitted to the hospital.
Abstract
Purpose: Frail older adults have a higher risk of hospital readmission due to decline in physical, functional, and psychological health status. The impact of readmission on individuals, families, or the healthcare system is tremendously devastating. This study aimed to investigate factors associated with hospital readmission of frail older adults. Materials and Methods: This was a retrospective descriptive study based on multi-professional health assessments found in elec tronic medical records of patients from a university-affiliated hospital in Seoul, Korea. The participants were 141 older adults who were admitted to the geriatric department with medical problems. Frailty, components of the comprehensive geriatric assess ment including nutrition, physical functions, psychological and cognitive status, clinical data including length of hospital stay, and readmission within 30, 90, and 180 days were collected. Survival analysis was performed, and Cox proportional hazard re gression model was used to investigate the risk factors for readmission. Results: The statistically significant variables at each time point were slightly different. However, at most time points, disease-relat ed problems (i.e., comorbidities and medications) and body functions (i.e., grip strength and physical activity) were included. The median duration until readmission was 27 days, and grip strength was found to be significantly related to readmission (p=0.020). Conclusion: After discharge, both medical services to manage the medical condition and intervention to maintain physical func tion are needed to prevent frail older adults from being readmitted to the hospital.
참고문헌 (32)
- Oubaya N, "Screening for frailty in elderly subjects living at home : validation of the modified short emergency geriatric assessment(SEGAm)instrument", J Nutr Health Aging, 18, pp.757~764 (2014)
- Fried LP, "Frailty in older adults : evidence for a phenotype", J Gerontol A Biol Sci Med Sci, 56, pp.M146~M157 (2001)
- Andreasen J, "Health-related quality of life at hospital discharge as a predictor for 6-month unplanned readmission and all-cause mortality of acutely admitted older medical patients", Qual Life Res, 28, pp.3015~3024 (2019)
- Cunha AIL, "Frailty as a predictor of adverse outcomes in hospitalized older adults : a systematic review and meta-analysis", Ageing Res Rev, 56, pp.100960~ (2019)
- Hao Q, "The role of frailty in predicting mortality and readmission in older adults in acute care wards : a prospective study", Sci Rep, 9, pp.1207~ (2019)
- Lee JY, "Does hospitalisation impact the successful ageing of community-dwelling older adults? : a propensity score matching analysis using the Korean national survey data", Int J Older People Nurs, 17, pp.e12413~ (2022)
- Pedersen MK, "Risk factors for acute care hospital readmission in older persons in Western countries : a systematic review", JBI Database System Rev Implement Rep, 15, pp.454~485 (2017)
- Chen CC, "Persistent cognitive decline in older hospitalized patients in Taiwan", J Adv Nurs, 66, pp.1991~2001 (2010)
- Gill TM, "Change in disability after hospitalization or restricted activity in older persons", JAMA, 304, pp.1919~1928 (2010)
- "Population projections for Korea: 2017-2067"[URL]
- Health Insurance Review & Assessment Service, "National Health Insurance Statistical Yearbook 2018" (2018), National Health Insurance Service and Health Insurance Review and Assessment Service of Korea
- Conroy SP, "A systematic review of comprehensive geriatric assessment to improve outcomes for frail older people being rapidly discharged from acute hospital : ‘interface geriatrics’", Age Ageing, 40, pp.436~443 (2011)
- Panayi AC, "Impact of frailty on outcomes in surgical patients : a systematic review and meta-analysis", Am J Surg, 218, pp.393~400 (2019)
- Kundi H, "Association of frailty with 30-day outcomes for acute myocardial infarction, heart failure, and pneumonia among elderly adults", JAMA Cardiol, 4, pp.1084~1091 (2019)
- García-Pérez L, "Risk factors for hospital readmissions in elderly patients : a systematic review", QJM, 104, pp.639~651 (2011)
- Heppenstall CP, "Readmissions to hospital in a frail older cohort receiving a community-based transitional care service", N Z Med J, 131, pp.38~45 (2018)
- 정희원, "The Korean version of the FRAIL scale: clinical feasibility and validity of assessing the frailty status of Korean elderly", The Korean Journal of Internal Medicine, 31(3), pp.594~600 (2016), 대한내과학회
- Morley JE, "A simple frailty questionnaire(FRAIL)predicts outcomes in middle aged African Americans", J Nutr Health Aging, 16, pp.601~608 (2012)
- Kaiser MJ, "Validation of the mini nutritional assessment short-form(MNA-SF) : a practical tool for identification of nutritional status", J Nutr Health Aging, 13, pp.782~788 (2009)
- 오지연, "한국어판 단문형 국제신처활동설문(IPAQ)의 신뢰도와 타당도", Korean Journal of Family Medicine, 28(7), pp.532~541 (2007), 대한가정의학회
- Won CW, "The development of Korean activities of daily living(K-ADL)and Korean instrumental activities of daily living(K-IADL)scale", J Korean Geriatr Soc, 6, pp.107~120 (2002)
- Tae Hui Kim, "Korean Version of Mini Mental Status Examination for Dementia Screening and Its Short Form", PSYCHIATRY INVESTIGATION, 7(2), pp.102~108 (2010), 대한신경정신의학회
- Kee BS, "A preliminary study for the standardization of geriatric depression scale short form-Korea version", J Korean Neuropsychiatr Assoc, 35, pp.298~307 (1996)
- Charlson M, "Validation of a combined comorbidity index", J Clin Epidemiol, 47, pp.1245~1251 (1994)
- Vidán MT, "Prevalence and prognostic impact of frailty and its components in non-dependent elderly patients with heart failure", Eur J Heart Fail, 18, pp.869~875 (2016)
- Park HY, "Prescribed drugs and polypharmacy in healthcare service users in South Korea : an analysis based on national health insurance claims data", Int J Clin Pharmacol Ther, 54, pp.369~377 (2016)
- Oh YH, "The health status of older Koreans and policy considerations", Health Welf Policy Forum, 223, pp.29~39 (2015)
- Rosted E, "Frailty and polypharmacy in elderly patients are associated with a high readmission risk", Dan Med J, 63, pp.A5274~ (2016)
- Stillman GR, "Frailty is associated with early hospital readmission in older medical patients", J Appl Gerontol, 40, pp.38~46 (2021)
- Craven E, "Hospital readmissions in frail older people", Rev Clin Gerontol, 25, pp.107~116 (2015)
- Joynt KE, "Thirty-day readmissions--truth and consequences", N Engl J Med, 366, pp.1366~1369 (2012)
- Andela RM, "Prevalence of frailty on clinical wards : description and implications", Int J Nurs Pract, 16, pp.14~19 (2010)