C Chauncey Spears1, Amir Besharat1, Erin Hastings Monari1, Daniel Martinez-Ramirez2, Leonardo Almeida1, Melissa J Armstrong3. 1. Department of Neurology, University of Florida College of Medicine, P.O. Box 100236, Gainesville, FL 32610, USA. 2. Department of Neurology, University of Florida College of Medicine, P.O. Box 100236, Gainesville, FL 32610, USA; Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Avenida Ignacio Morones Prieto 3000 Poniente, Los Doctores, 64710 Monterrey, NL, Mexico. 3. Department of Neurology, University of Florida College of Medicine, P.O. Box 100236, Gainesville, FL 32610, USA. Electronic address: melissa.armstrong@neurology.ufl.edu.
Abstract
INTRODUCTION: Understanding hospitalization in Lewy body dementia (LBD) is a known knowledge gap. We aimed to identify common causes, medication profiles, complications, and outcomes of hospitalization in LBD. METHODS: A retrospective cohort study investigated details of academic medical center hospitalizations over a two-year period for patients with LBD. Data collected included demographics, home medications, pre-hospital living status, reason for admission, admission service, inpatient medications, complications, and discharge status. Non-parametric statistics assessed associations between variables and length of stay. Odds of a change in living situation based on admission variables was calculated. RESULTS: The study included 178 hospitalizations (117 individuals). Neuropsychiatric symptoms were the most common admission reason (40%), followed by falls (24%) and infection (23%). Patients were usually admitted to medicine services; neurology or psychiatric consultations occurred less than 40% of the time. Antipsychotics were administered during 38% of hospitalizations. Use of antipsychotics other than quetiapine or clozapine was associated with longer length of stay and increased odds of discharge to a higher level of care. One-third of hospitalizations resulted in transition to a higher level of care; 15% ended in hospice care or death. CONCLUSION: The most common reasons for hospitalization in LBD are potentially modifiable. Opportunities for improved care include increased involvement of neurological and psychiatric services, delirium prevention strategies, and reduced antipsychotic use. Clinicians should counsel patients and families that hospitalizations in LBD can be associated with end of life. Research is needed to identify strategies to prevent hospitalization and optimal standards for inpatient care. FUNDING: Lewy body dementia research at the University of Florida is supported by the University of Florida Dorothy Mangurian Headquarters for Lewy Body Dementia and the Raymond E. Kassar Research Fund for Lewy Body Dementia.
INTRODUCTION: Understanding hospitalization in Lewy body dementia (LBD) is a known knowledge gap. We aimed to identify common causes, medication profiles, complications, and outcomes of hospitalization in LBD. METHODS: A retrospective cohort study investigated details of academic medical center hospitalizations over a two-year period for patients with LBD. Data collected included demographics, home medications, pre-hospital living status, reason for admission, admission service, inpatient medications, complications, and discharge status. Non-parametric statistics assessed associations between variables and length of stay. Odds of a change in living situation based on admission variables was calculated. RESULTS: The study included 178 hospitalizations (117 individuals). Neuropsychiatric symptoms were the most common admission reason (40%), followed by falls (24%) and infection (23%). Patients were usually admitted to medicine services; neurology or psychiatric consultations occurred less than 40% of the time. Antipsychotics were administered during 38% of hospitalizations. Use of antipsychotics other than quetiapine or clozapine was associated with longer length of stay and increased odds of discharge to a higher level of care. One-third of hospitalizations resulted in transition to a higher level of care; 15% ended in hospice care or death. CONCLUSION: The most common reasons for hospitalization in LBD are potentially modifiable. Opportunities for improved care include increased involvement of neurological and psychiatric services, delirium prevention strategies, and reduced antipsychotic use. Clinicians should counsel patients and families that hospitalizations in LBD can be associated with end of life. Research is needed to identify strategies to prevent hospitalization and optimal standards for inpatient care. FUNDING: Lewy body dementia research at the University of Florida is supported by the University of Florida Dorothy Mangurian Headquarters for Lewy Body Dementia and the Raymond E. Kassar Research Fund for Lewy Body Dementia.
Authors: Margaret Wiggins; Franchesca Arias; Richard D Urman; Deborah C Richman; Bobbie Jean Sweitzer; Angela F Edwards; Melissa J Armstrong; Anita Chopra; David J Libon; Catherine Price Journal: Perioper Care Oper Room Manag Date: 2020-02-05
Authors: Li Mo; Yimin Geng; Yuchieh Kathryn Chang; Jennifer Philip; Anna Collins; David Hui Journal: J Am Geriatr Soc Date: 2021-03-02 Impact factor: 7.538
Authors: Xin Wang; Chika F Ezeana; Lin Wang; Mamta Puppala; Yan-Siang Huang; Yunjie He; Xiaohui Yu; Zheng Yin; Hong Zhao; Eugene C Lai; Stephen T C Wong Journal: Alzheimers Dement (N Y) Date: 2022-09-29