Christopher N Osuafor1,2, Syazwani N M Sahimi3, Sree Enduluri3, Frances McCarthy3,4. 1. Department of Medicine for the Elderly, St Mary's Hospital, Phoenix Park, Dublin, Ireland. chrisosuafor@gmail.com. 2. Department of Medicine for the Elderly, Addenbrookes Hospital, Hills Road, Cambridge, United Kingdom. chrisosuafor@gmail.com. 3. Department of Medicine for the Elderly, St Mary's Hospital, Phoenix Park, Dublin, Ireland. 4. University College Dublin, Belfield, Ireland.
Abstract
BACKGROUND AND AIMS: Elderly rehabilitation programs provide a period of rehabilitation to optimize a safe home discharge after acute hospitalization of older adults. Often, these patients may have their rehabilitation interrupted when they become unwell and subsequently require transfer back to an acute hospital setting. We will look at the incidence and outcome of this interruption. This paper aimed to determine the incidence of interrupted post-acute geriatric rehabilitation requiring acute hospital transfer and to analyze the outcome of the transfers. METHODS: An analysis of a retrospective cohort of elderly patients admitted into a 22-bed community-based geriatric rehabilitation unit over a 48-month period. RESULTS: Five hundred thirty-nine patients were admitted for rehabilitation. Fifty (9.3%) patients had their rehabilitation interrupted and were transferred to an acute hospital setting. Sixty-six percent were females; mean age 82.1 ± 8.7 years. Final diagnosis was acute severe infections (44%), traumatic fracture secondary to fall (10%), intraabdominal complications (10%), cardiac complications (8%), and acute neurological event (6%). Of these patients, 42% had a fatal outcome while 32% returned for rehabilitation. CONCLUSION: Interrupted geriatric rehabilitation requiring acute hospital transfer occurred in 9.3% of patients; acute severe infection was the most common cause. These transfers were associated with significant mortality. Rehabilitation programs should focus improvement efforts on identifying suitable patients for rehabilitation, optimizing care transitions, and minimizing rates of transfers.
BACKGROUND AND AIMS: Elderly rehabilitation programs provide a period of rehabilitation to optimize a safe home discharge after acute hospitalization of older adults. Often, these patients may have their rehabilitation interrupted when they become unwell and subsequently require transfer back to an acute hospital setting. We will look at the incidence and outcome of this interruption. This paper aimed to determine the incidence of interrupted post-acute geriatric rehabilitation requiring acute hospital transfer and to analyze the outcome of the transfers. METHODS: An analysis of a retrospective cohort of elderly patients admitted into a 22-bed community-based geriatric rehabilitation unit over a 48-month period. RESULTS: Five hundred thirty-nine patients were admitted for rehabilitation. Fifty (9.3%) patients had their rehabilitation interrupted and were transferred to an acute hospital setting. Sixty-six percent were females; mean age 82.1 ± 8.7 years. Final diagnosis was acute severe infections (44%), traumatic fracture secondary to fall (10%), intraabdominal complications (10%), cardiac complications (8%), and acute neurological event (6%). Of these patients, 42% had a fatal outcome while 32% returned for rehabilitation. CONCLUSION: Interrupted geriatric rehabilitation requiring acute hospital transfer occurred in 9.3% of patients; acute severe infection was the most common cause. These transfers were associated with significant mortality. Rehabilitation programs should focus improvement efforts on identifying suitable patients for rehabilitation, optimizing care transitions, and minimizing rates of transfers.
Authors: Noor Heim; Herbert Rolden; Esther M van Fenema; Annelies W E Weverling-Rijnsburger; Jolien P Tuijl; Peter Jue; Anna M Oleksik; Anton J M de Craen; Simon P Mooijaart; Gerard Jan Blauw; Rudi G J Westendorp; Roos C van der Mast; Irma E C van Everdinck Journal: Age Ageing Date: 2016-06-13 Impact factor: 10.668
Authors: Kenneth E Covinsky; Robert M Palmer; Richard H Fortinsky; Steven R Counsell; Anita L Stewart; Denise Kresevic; Christopher J Burant; C Seth Landefeld Journal: J Am Geriatr Soc Date: 2003-04 Impact factor: 5.562