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Discharge diagnosis and comorbidity profile in hospitalized older patients with dementia
Author(s) -
Zuliani Giovanni,
Galvani Matteo,
Sioulis Fotini,
Bonetti Francesco,
Prandini Stefano,
Boari Benedetta,
Guerzoni Franco,
Gallerani Massimo
Publication year - 2012
Publication title -
international journal of geriatric psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.28
H-Index - 129
eISSN - 1099-1166
pISSN - 0885-6230
DOI - 10.1002/gps.2722
Subject(s) - medicine , comorbidity , dementia , delirium , medical diagnosis , mortality rate , diabetes mellitus , pediatrics , disease , intensive care medicine , pathology , endocrinology
Objectives The aim of this study was to investigate the principal discharge diagnosis and related comorbidity in hospitalized older patients affected by dementia. Methods Data from 51,838 consecutive computerized discharge records of the St. Anna University Hospital (Ferrara, Italy) were analyzed. Records included only subjects aged ≥60 years. Number of admissions, length of stay in hospital, primary and secondary discharge diagnosis (by ICD‐9‐CM code), number of procedures, and possible death were evaluated. Results Demented patients represented 8.6% of the sample (4466 individuals) and were older and more likely to be female patients compared with controls (47,372 individuals); they were characterized by higher number of admissions to hospital, instrumental clinical investigations, secondary diagnoses, and mortality rate. Among the primary diagnoses, a higher prevalence of cerebrovascular disease, pneumonia, and hip fracture was observed in demented patients. Furthermore, pulmonary embolism, renal failure, septicemia, and urinary infections were frequently reported in demented patients, but not in controls. As regards secondary diagnoses, dementia was associated with an increased risk of delirium, muscular atrophy and immobilization, dehydration, cystitis, and pressure ulcers, whereas the risk for other conditions, including cancer, was reduced. Conclusions Among older patients, dementia was associated with higher rate of admissions to hospital and mortality. Discharge diagnoses were sensibly different according to the presence of dementia; in particular, a greater load and a different kind of comorbidity were observed in demented patients. On the whole, our data suggest that the adequate management of demented outpatients might help to reduce hospitalization. Copyright © 2011 John Wiley & Sons, Ltd.