Davide L Vetrano1, Francesco Landi2, Stefanie L De Buyser3, Angelo Carfì2, Giuseppe Zuccalà4, Mirko Petrovic3, Stefano Volpato5, Antonio Cherubini6, Andrea Corsonello7, Roberto Bernabei2, Graziano Onder2. 1. Department of Geriatrics, Orthopaedics and Neurosciences, Catholic University of Sacred Heart, Rome, Italy. Electronic address: davidevetrano@gmail.com. 2. Department of Geriatrics, Orthopaedics and Neurosciences, Catholic University of Sacred Heart, Rome, Italy. 3. Department of Geriatrics, Ghent University Hospital, Ghent, Belgium. 4. Emergency Department, Catholic University of Sacred Heart, Rome, Italy. 5. Department of Medical Sciences, University of Ferrara, Ferrara, Italy. 6. Geriatrics, Research Hospital of Ancona, IRCCS, Italian National Research Centre on Aging (INRCA), Ancona, Italy. 7. Unit of Geriatric Pharmaco-epidemiology, IRCCS, Italian National Research Centre on Aging (INRCA), Cosenza, Italy.
Abstract
BACKGROUND: Reduction in length of hospital stay (LOS) is considered as a potential strategy to optimize resource consumption and reduce health care costs. We analysed predictors of increased LOS among older patients admitted to acute care wards according to type of admission (through the Emergency Room [ER] or elective). METHODS: We analysed data of 1123 older patients, aged 65years or older, consecutively admitted to seven acute care wards. LOS was defined as the number of days from admission to discharge (or death) and categorized according to its median value (10days). RESULTS: Mean age of participants was 81±7years and 56% were women. Patients admitted through ER had a shorter LOS compared with those elective (10.4±6.7 vs. 12.0±6.7days; p<0.0001). Factors associated with LOS >10days, for patients admitted through ER, were female gender (OR 0.58; 95% C.I. 0.37-0.90), erythrocyte sedimentation rate (OR 1.02; 95% C.I. 1.01-1.03), and excessive polypharmacy (use of ≥10 drugs during stay) (OR 3.60; 95% C.I. 1.40-9.25). Predictors for elective patients were chronic alcohol consumption (OR 0.54; 95% C.I. 0.32-0.93), walking speed ≥0.8m/s (OR 0.31; 95% C.I. 0.14-0.72), excessive polypharmacy (OR 4.78; 95% C.I. 1.92-11.90), pressure ulcers (OR 2.60; 95% C.I. 1.01-6.79), cerebrovascular disease (OR 0.49; 95% C.I. 0.24-0.99) and dementia (OR 0.18; 95% C.I. 0.08-0.39). CONCLUSIONS: LOS differed between patients admitted through emergency and through elective admission. Demographic and clinical parameters can affect LOS and polypharmacy was the strongest and the only common risk factor in both groups.
BACKGROUND: Reduction in length of hospital stay (LOS) is considered as a potential strategy to optimize resource consumption and reduce health care costs. We analysed predictors of increased LOS among older patients admitted to acute care wards according to type of admission (through the Emergency Room [ER] or elective). METHODS: We analysed data of 1123 older patients, aged 65years or older, consecutively admitted to seven acute care wards. LOS was defined as the number of days from admission to discharge (or death) and categorized according to its median value (10days). RESULTS: Mean age of participants was 81±7years and 56% were women. Patients admitted through ER had a shorter LOS compared with those elective (10.4±6.7 vs. 12.0±6.7days; p<0.0001). Factors associated with LOS >10days, for patients admitted through ER, were female gender (OR 0.58; 95% C.I. 0.37-0.90), erythrocyte sedimentation rate (OR 1.02; 95% C.I. 1.01-1.03), and excessive polypharmacy (use of ≥10 drugs during stay) (OR 3.60; 95% C.I. 1.40-9.25). Predictors for elective patients were chronic alcohol consumption (OR 0.54; 95% C.I. 0.32-0.93), walking speed ≥0.8m/s (OR 0.31; 95% C.I. 0.14-0.72), excessive polypharmacy (OR 4.78; 95% C.I. 1.92-11.90), pressure ulcers (OR 2.60; 95% C.I. 1.01-6.79), cerebrovascular disease (OR 0.49; 95% C.I. 0.24-0.99) and dementia (OR 0.18; 95% C.I. 0.08-0.39). CONCLUSIONS: LOS differed between patients admitted through emergency and through elective admission. Demographic and clinical parameters can affect LOS and polypharmacy was the strongest and the only common risk factor in both groups.
Authors: M Arcopinto; M Cataldi; V De Luca; V Orlando; G Simeone; R D'Assante; A Postiglione; A Guida; U Trama; M Illario; N Ferrara; E Coscioni; G Iaccarino; P Cuccaro; G D'Onofrio; C Vigorito; A Cittadini; E Menditto Journal: Transl Med UniSa Date: 2017-07-01
Authors: Stefanie L De Buyser; Mirko Petrovic; Youri E Taes; Davide L Vetrano; Andrea Corsonello; Stefano Volpato; Graziano Onder Journal: PLoS One Date: 2014-05-12 Impact factor: 3.240