Postdischarge adverse events for 1-day hospital admissions in older adults admitted from the emergency department.
Publication/Presentation Date
9-1-2010
Abstract
STUDY OBJECTIVE: We assess hospital readmission and death within 60 days in older adults admitted from the emergency department (ED) and discharged by an inpatient service within 24 hours.
METHODS: This was a retrospective review of ED patients aged 64 years or older, admitted from 2 hospitals (2004 to 2006), who were discharged home within 24 hours. Excluded were in-hospital deaths, observation admissions, transfers to other facilities, patients who left against medical advice, and hospice patients. Outcomes were 72-hour and 30-day readmissions and postdischarge deaths that occurred within 60 days of ED admission. Logistic regression was used to assess for predictors of readmission. A chart review of deaths after discharge was performed to assess for potential contributors to adverse outcomes.
RESULTS: A total of 1,470 admissions met inclusion criteria as 1-day admissions. Of those, 22 (1.5%) patients returned for hospital readmission within 72 hours and 156 (10.6%) within 30 days of discharge. In the multivariable analysis, previous admissions (odds ratio [OR] 1.3; 95% confidence interval [CI] 1.1 to 1.4) and an admission diagnosis of heart failure (OR 2.2; 95% CI 1.0 to 5.0) were associated with 30-day readmission. In 841 individual patients with greater than or equal to one 1-day admission, there were 15 deaths (1.8%) within 60 days. Of those, 11 (73%) patients had abnormal ED ECG results, 6 (40%) were ruled out for acute myocardial infarction while hospitalized, and 3 (20%) had definitive follow-up arranged at discharge.
CONCLUSION: One-day admissions in hospitalized older adults through the ED do not represent a group at low risk for postdischarge adverse outcomes.
Volume
56
Issue
3
First Page
253
Last Page
257
ISSN
1097-6760
Published In/Presented At
Pines, J. M., Mongelluzzo, J., Hilton, J. A., Hollander, J. E., Shofer, F. S., Souder, J., Synnestvedt, M., Weiner, M. G., & Datner, E. M. (2010). Postdischarge adverse events for 1-day hospital admissions in older adults admitted from the emergency department. Annals of emergency medicine, 56(3), 253–257. https://doi.org/10.1016/j.annemergmed.2010.01.031
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
20189266
Department(s)
Administration and Leadership
Document Type
Article