Abstract

ObjectiveTo evaluate the risk factors associated with 30- and 90-day hospital readmissions in geriatric rehabilitation inpatients. DesignObservational, prospective longitudinal inception cohort. SettingTertiary hospital in Victoria, Australia. ParticipantsGeriatric rehabilitation inpatients of the REStORing Health of Acutely Unwell AdulTs (RESORT) cohort evalutated by a comprehensive geriatric assessment including potential readmission risk factors (ie, demographic, social support, lifestyle, functional performance, quality of life, morbidity, length of stay in an acute ward). Of 693 inpatients, 11 died during geriatric rehabilitation. The mean age of the remaining 682 inpatients was 82.2±7.8 years, and 56.7% were women. InterventionsNot applicable. Main Outcome MeasuresThirty- and 90-day readmissions after discharge from geriatric inpatient rehabilitation. ResultsThe 30- and 90-day unplanned all-cause readmission rates were 11.6% and 25.2%, respectively. Risk factors for 30- and 90-day readmissions were as follows: did not receive tertiary education, lower quality of life, higher Charlson Comorbidity Index and Cumulative Illness Rating Scale (CIRS) scores, and a higher number of medications used in the univariable models. Formal care was associated with increased risk for 90-day readmissions. In multivariable models, CIRS score was a significant risk factor for 30-day readmissions, whereas high fear of falling and CIRS score were significant risk factors for 90-day readmissions. ConclusionsHigh fear of falling and CIRS score were independent risk factors for readmission in geriatric rehabilitation inpatients. These variables should be included in hospital readmission risk prediction model developments for geriatric rehabilitation inpatients.

Highlights

  • This study aimed to identify risk factors associated with the risk of 30- and 90-day hospital readmissions in geriatric rehabilitation inpatients

  • REStORing Health of Acutely Unwell AdulTs (RESORT) is an ongoing observational, longitudinal inception cohort from October 16, 2017 onwards using a comprehensive geriatric assessment (CGA) to investigate the characteristics and health outcomes of inpatients recruited from geriatric rehabilitation wards at the Royal Melbourne Hospital

  • A median Charlson Comorbidity Index (CCI) score of 2 (IQR, 1-4) and a median of 6 (IQR, 5-8) systems were affected in Cumulative Illness Rating Scale (CIRS)

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Summary

Methods

REStORing Health of Acutely Unwell AdulTs (RESORT) is an ongoing observational, longitudinal inception cohort from October 16, 2017 onwards using a comprehensive geriatric assessment (CGA) to investigate the characteristics and health outcomes of inpatients recruited from geriatric rehabilitation wards at the Royal Melbourne Hospital. Older and frailer adults tending to have multimorbidity who require multidisciplinary rehabilitation care for recovery after acute episodes of ill-health are transferred to geriatric rehabilitation wards. Patients were excluded if they were receiving palliative care at admission, incapable of providing informed consent without a nominated proxy, or transferring to acute care prior to consenting to the study

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