Early geriatric follow-up after discharge reduces mortality among patients living in their own home. A randomised controlled trial - 30/08/17
Abstract |
Introduction |
Post-hospital mortality rates are high among geriatric patients. Early geriatric follow-up has resulted in a significant reduction in readmission rate and length of hospital stay (LOS). With a reduction of LOS mortality becomes a major issue.
Material and method |
The study is a quasi-randomised, controlled trial. Participants are geriatric patients 75years or older, admitted to emergency department with one of following diagnoses: pneumonia, chronic obstructive pulmonary disease, dehydration, delirium, constipation, anaemia, heart failure, urinary tract infection, or other infections. Intervention group patients receive a follow-up visit by a geriatric team nurse and doctor on the first weekday after hospital discharge. Control group patients are screened by hospital staff for a visit by general practitioner and community nurse 7–14days after discharge.
Results |
A total of 1060 patients were allocated to intervention group and 1016 patients to control group. The 90-day mortality of the entire population was not significantly affected by the intervention (23% vs. 26%). Hazard ratio=0.87 (95% CI 0.73–1.03). However, 90-day mortality of patients living in their own home was significantly reduced (18% vs. 22%). Hazard ratio=0.79 (95% CI 0.63–0.99). Among nursing home residents 90-day mortality did not differ between the groups. Hazard ratio=1.01 (95% CI 0.77–1.32). The 30-day mortality was not significantly affected by the intervention.
Conclusion |
Early geriatric follow-up after discharge is a safe way of reducing readmissions and LOS among geriatric patients admitted acutely to hospital. Patients living in their own home may even benefit more from the intervention.
Le texte complet de cet article est disponible en PDF.Keywords : Follow-up visit, Mortality, Hospitalization, Geriatric patients, Length of hospital stay, Readmission
Plan
Vol 8 - N° 4
P. 330-336 - septembre 2017 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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