The Impact of Hospitalization on Readmission, Institutionalization, and Mortality of People with Dementia: A Systematic Review and Meta-Analysis
| Autor: | Jana Lehmann, Anika Kaczynski, Jochen René Thyrian, Alexander Esser, Wolfgang Hoffmann, Bernhard Michalowsky, Ina Zwingmann, Nele Sophie Schenk |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
Activities of daily living Institutionalisation epidemiology [Dementia] therapy [Dementia] Patient Readmission 03 medical and health sciences 0302 clinical medicine statistics & numerical data [Patient Discharge] Medicine Dementia Humans statistics & numerical data [Institutionalization] 030212 general & internal medicine ddc:610 statistics & numerical data [Patient Readmission] statistics & numerical data [Hospitalization] business.industry General Neuroscience Incidence (epidemiology) mortality [Dementia] Institutionalization General Medicine medicine.disease Readmission rate Patient Discharge Hospitalization Psychiatry and Mental health Clinical Psychology Care in the Community Meta-analysis Relative risk Emergency medicine Geriatrics and Gerontology business 030217 neurology & neurosurgery |
| Zdroj: | Journal of Alzheimer's disease 64(3), 735-749 (2018). doi:10.3233/JAD-171128 |
| DOI: | 10.3233/JAD-171128 |
| Popis: | Background People with dementia (PwD) are at a high risk of hospitalization. Hospitals are often not adequately equipped for PwD and discharges often come unexpected. Therefore, PwD are at a risk of adverse outcomes. However, information about those outcomes is rare but crucial for the development of preventive strategies. Objectives To conduct a quantitative systematic review and meta-analyses on the impact of a hospitalization on readmission, institutionalization, and mortality in PwD. To identify factors associated with these outcomes. Methods PubMed, CENTRAL, and ScienceDirect were searched for studies including terms for dementia, hospital, readmission, institutionalization, and mortality. Relevant were assessed by a quality criteria sheet. Results were summarized in a table. Meta-analysis was conducted with Review Manager 5.3. Results The search yielded 1,108 studies; 20 fulfilled the inclusion criteria and 10 studies were eligible for meta-analyses. The incidence and relative risk (RR) of mortality (RR 1.74 CI95 % 1.50, 2.05) and institutionalization (RR: 2.16 CI95 % 1.31, 3.56) of PwD was significantly higher when compared to people without dementia. Results according to readmission rate were inconsistent. Factors significantly associated with the examined adverse outcomes were severity of dementia, number of medications, and deficits in daily living activities. Conclusion Hospitalization of PwD lead to adverse outcomes. An improvement in the identification of and care for PwD in the acute setting as well as in after care in the community setting, especially in the interface between both settings, is required to prevent adverse outcomes in hospitalized PwD. |
| Databáze: | OpenAIRE |
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