Abstract
For elderly inpatients, it may be preferable to return back to their homes after discharge. Therefore, it is important to predict whether elderly patients are able to return home after discharge. Our purpose is to examine the association between geriatric factors including oral conditions and returning home after discharge in elderly patients. A total of 257 elderly patients were enrolled (returned home: N = 116; changed to hospital/nursing home: N = 141). Oral conditions were evaluated by trained dentists. Cognitive impairment was evaluated using the clinical dementia rating scale. Odds ratios (OR) and 95% confidence intervals (CI) to predict the destination after discharge were obtained by unconditional logistic regression analysis. Impaired tongue movement and edentulous were significant oral factors that elderly patients cannot return home (Impaired tongue movement, OR: 2.72; Edentulous, OR, 1.89), whereas presence of loss of posterior occlusion and mobile teeth were not associated statistically. Cognitive impairment, but not aftereffect of cerebrovascular disease, was a significant problem to predict the destination after discharge in elderly patients (Cognitive impairment, OR: 3.58; Cerebrovascular disease, OR: 1.27). Simple, reliable and inexpensive evaluation including oral examination may better predict whether elderly patients can return home after discharge.
Highlights
Japan is a steadily aging society, and the number of hospitalized elderly patients has been increasing [1]
Severity of the diseases must be considered as a significant factor to decide the destination after hospital discharge, it may be preferable for elderly patients to return back to their homes after hospital discharge
Cognitive impairment and aspiration pneumonia were significant systemic geriatric factors to predict that the elderly patients cannot return home after hospital discharge (OR, 2.47, 95% confidence intervals (CI): 1.3–4.6, p = 0.0034), whereas presence of aftereffect of cerebrovascular disease was not associated with the destination (OR, 1.27, 95% CI: 0.77–2.1, p = 0.35)
Summary
Japan is a steadily aging society, and the number of hospitalized elderly patients has been increasing [1]. They are very pleased to return back to their home after hospital discharge. Various geriatric factors, i.e., lower body mass index (BMI), diminished physical recovery, oral frailty, aftereffect of cerebrovascular disease and cognitive impairment are closely related to each other in elderly patients, resulting in development of unwanted lethal diseases such as aspiration pneumonia [2,3]. It is well known that the maintenance of good oral hygiene is important to reduce the risk of aspiration pneumonia, the oral hygiene of elderly patients is often very poor because of disabled limbs by several geriatric factors such as aftereffect of cerebrovascular disease or cognitive impairment [3]. In view of the residence of elderly patients after discharge, it is very important to predict whether elderly inpatients can return to their home after discharge, because their family can prepare a good care plan in advance
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