Identification of risk factors associated withunplanned readmission, palliative decision ormortality within 30 days at the acute admissionsunit during 2019 – a retrospective cohort study.

• Main Author: Dahlgren, Ida
• Format: Others
• Language: English
• Published: Örebro universitet, Institutionen för medicinska vetenskaper 2020
• Subjects: readmission; mortality; National Early Warning Score (NEWS); municipality support; clinical frailty scale (CFS); Medical and Health Sciences; Medicin och hälsovetenskap
• Online Access: http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-86724

Introduction: A recent study at the acute admission unit (AAU), revealed that 13.5 percent ofall patients discharged from the department, were readmitted within 30 days during 2018. Inthe group of 80 years and above, the cause for re-admission was multifactorial. Aim: To identify factors that are associated with unplanned re-admission, palliative decision,or death within 30 days after discharge from the AAU, in patients of 80 years or above. Anotheraim is to examine if longer hospital stay, patient discharge planning and fast follow-up canprotect against these outcomes. Methods: A retrospective cohort study comprising 287 patients. Data on age, sex, length ofstay, comorbidities (Elixhauser comorbidity index), frailty (Clinical frailty scale), NationalEarly Warning Score (NEWS), social status, home care, lab values and outcome were collected.All variables were analyzed using Chi-square test with univariate and multivariate logisticregression, and a p-value < 0.05 was considered statistically significant. Results: 276 patients were included. A NEWS ≥ 3 was associated with significantly increasedrisk for poor outcome (odds ratio 2.4). Living with someone without municipal support wasassociated with a significantly decreased risk for poor outcome (odds ratio 0.21). Conclusions: The results indicate that it is crucial to stabilize patients of 80 years or abovebefore discharge. And that living with someone without municipal support is a protective factor.