Back-UPUG: Risk Factors at Emergency Admission for Early Unplanned Readmissions in Older Adults Following Short-Stay Geriatric Hospitalization After Emergency Care

Back-UPUG:老年人在急诊护理后短期住院治疗后早期非计划再入院的急诊入院风险因素

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Abstract

INTRODUCTION: Specific short-stay Post-Emergency Geriatric Units (PEGUs) might reduce length of stay and iatrogenic loss of independence without increasing the risk of early readmission. The aim of this study was to evaluate the rate and risk factors at emergency admission for early rehospitalization in a PEGU. METHODS: The BACK-UPUG study is a retrospective observational study conducted at a Post-Emergency Geriatric Unit (University Hospital of Angers) over nearly 1 year, including patients hospitalized in the unit and discharged home. The early readmission rate within 30 days after discharge was calculated, and statistical descriptive, univariate, and multivariate analyses were carried out. RESULTS: A total of 450 patients were included in the analysis (mean age 88 years; 39.3% men, 60.7% women). Of these, 75 patients (16.6%) were readmitted within 1 month after home discharge. Early readmission rate was significantly associated with excessive polypharmacy (odds ratio [OR] = 1.95; p = 0.014), being known by our geriatric team (OR = 2.36; p = 0.001), a history of recent hospitalization (OR = 2.00; p = 0.038), and initial severity criteria such as respiratory failure (OR = 1.94; p = 0.049) or hemodynamic disorders (OR = 3.91; p = 0.029). An initial hospital admission diagnosis of infectious disease was a protective factor (OR = 0.45; p = 0.023). CONCLUSION: Excessive polypharmacy, geriatric team follow-up, recent hospitalization, and initial severity criteria are risk factors for early rehospitalization after emergency PEGU admission, while infectious pathology appears protective.

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