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Geriatr Gerontol Int. 2018 Oct;18(10):1513-1518. doi: 10.1111/ggi.13518. Epub 2018 Sep 17.

Thirty-day hospital readmission rate amongst older adults correlates with an increased number of medications, but not with Beers medications.

Author information

1
Department of Anesthesiology, Division of Critical Care Medicine Washington University School of Medicine, St. Louis, Missouri, USA.
2
Department of Medicine, Hofstra-Northwell Health School of Medicine, Great Neck, New York, USA.
3
Biostatistics Unit, the Feinstein Institute for Medical Research, Northwell Health, Manhasset, New York, USA.
4
Department of Geriatrics, Hofstra-Northwell Health School of Medicine, Great Neck, New York, USA.

Abstract

AIM:

We sought to explore the relationship between the number of medications at hospital discharge and 30-day rehospitalization in older adults aged >65 years.

METHODS:

This was a multicenter cohort study to determine whether an increased number of medications was associated with 30-day rehospitalization in patients aged >65 years. We explored the relationship between rehospitalization and other risk factors. Data were collected from a large health system in the New York metropolitan area from September 2011 to January 2013. The primary outcome was 30-day hospital readmission from the index hospitalization.

RESULTS:

Patients had a mean ± SD age of 78 ± 9 years; 55% were women. The average length of stay after discharge from the hospital was 6 days. An increased number of medications was significantly associated with unplanned 30-day hospital readmission (P < 0.05). For each medication, the risk of rehospitalization increased by 4% (OR 1.04, 95% CI 1.03, 1.05). Patients discharged to rehabilitation centers were 32% more likely to be readmitted than patients discharged home (OR 1.39, 95% CI 1.27-1.51). Other risk factors significantly associated with 30-day rehospitalization were: cancer, intensive care unit, chronic heart failure, renal diseases and peripheral vascular diseases. Hypertension was negatively associated with 30-day unplanned rehospitalization (OR 0.88, 95% CI 0.82-0.95). No significant association between the number of Beers medications and 30-day rehospitalization was observed, after controlling for the number of medications and other covariates.

CONCLUSIONS:

The number of discharge medications was significantly associated with 30-day hospital readmission among older adult patients. Important risk factors for 30-day rehospitalization were discharge location, cancer, intensive care unit, chronic heart failure, renal diseases and peripheral vascular diseases. Geriatr Gerontol Int 2018; 18: 1513-1518.

KEYWORDS:

hospital readmission; medical history; medications; older adults

PMID:
30225904
DOI:
10.1111/ggi.13518
[Indexed for MEDLINE]

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