Predicting the in-patient outcomes of acute medical admissions from the nursing home: The experience of St James's Hospital, Dublin, 2002-2010

Geriatrics and Gerontology International

Volumn 12, Issue 4, 2012, Pages 703-713

  Romero Ortuno, Roman ^a   O'Shea, Diarmuid ^b   Silke, Bernard ^a  

^a ST JAMES S HOSPITAL   (Ireland)

^b ST VINCENT S UNIVERSITY HOSPITAL   (Ireland)

Author keywords

Acute disease; Hospitalization; Length of stay; Mortality; Nursing homes

Indexed keywords

ALBUMIN; OXYGEN; POTASSIUM; SODIUM; TROPONIN; UREA;

AGED; ALBUMIN BLOOD LEVEL; ARTICLE; BODY TEMPERATURE; BREATHING RATE; COMORBIDITY; DIASTOLIC BLOOD PRESSURE; EMERGENCY CARE; FEMALE; GASTROINTESTINAL DISEASE; GROUPS BY AGE; HEART RATE; HEMATOCRIT; HOSPITAL ADMISSION; HOSPITAL PATIENT; HUMAN; ISCHEMIA; KIDNEY DISEASE; LENGTH OF STAY; LEUKOCYTE COUNT; MAJOR CLINICAL STUDY; MALE; MORTALITY; NEUROLOGIC DISEASE; NURSING HOME PATIENT; OUTCOME ASSESSMENT; OXYGEN SATURATION; POTASSIUM BLOOD LEVEL; PRIORITY JOURNAL; PROTEIN BLOOD LEVEL; RESPIRATORY TRACT DISEASE; RETROSPECTIVE STUDY; SODIUM BLOOD LEVEL; SYSTOLIC BLOOD PRESSURE; UREA BLOOD LEVEL; URINARY TRACT DISEASE;

ACUTE DISEASE; AGED; AGED, 80 AND OVER; BIOLOGICAL MARKERS; CHI-SQUARE DISTRIBUTION; COMORBIDITY; FEMALE; HOSPITAL MORTALITY; HOSPITALIZATION; HUMANS; IRELAND; LENGTH OF STAY; MALE; NURSING HOMES; PREDICTIVE VALUE OF TESTS; RETROSPECTIVE STUDIES; RISK FACTORS; STATISTICS, NONPARAMETRIC;

EID: 84866748932     PISSN: 14441586     EISSN: 14470594     Source Type: Journal    
DOI: 10.1111/j.1447-0594.2012.00847.x     Document Type: Article

References (59)

1. Murray LM, Laditka SB. Care transitions by older adults from nursing homes to hospitals: implications for long-term care practice, geriatrics education, and research. J Am Med Dir Assoc 2010; 11: 231-238.
2. Arendts G, Howard K. The interface between residential aged care and the emergency department: a systematic review. Age Ageing 2010; 39: 306-312.
3. Gozalo P, Teno JM, Mitchell SL etal. End-of-life transitions among nursing home residents with cognitive issues. N Engl J Med 2011; 365: 1212-1221.
4. Partridge J. Why are nursing home residents sent in to hospital to die? Postgrad Med J 2008; Jun; 84 (992): 281.
5. Chan TC, Shea YF, Luk KH, Chan HW, Chu LW. Development and validation of a prognostic index for 2-year mortality in Chinese older residents living in nursing homes. Geriatr Gerontol Int 2012. doi: 10.1111/j.1447-0594.2011.00804.x
6. Gronstedt H, Hellstrom K, Bergland A etal. Functional level, physical activity and wellbeing in nursing home residents in three Nordic countries. Aging Clin Exp Res 2011. doi: 10.3275/7507
7. Manton KG, Liu K, Cornelius ES. An analysis of the heterogeneity of U.S. nursing home patients. J Gerontol 1985; Jan; 40 (1): 34-46.
8. Przybylski BR, Dumont ED, Watkins ME, Warren SA, Beaulne AP, Lier DA. Outcomes of enhanced physical and occupational therapy service in a nursing home setting. Arch Phys Med Rehabil 1996; 77: 554-561.
9. Smith M, Romero-Ortuno R, Hughes G, O'Shea D, Cogan L. An integrated model of complex continuing care: the experience of The Royal Hospital Donnybrook 2009-2010. Ir J Med Sci 2011; 180 (Suppl 10): S330.
10. Strohbuecker B, Eisenmann Y, Galushko M, Montag T, Voltz R. Palliative care needs of chronically ill nursing home residents in Germany: focusing on living, not dying. Int J Palliat Nurs 2011; Jan; 17 (1): 27-34.
11. Tolson D, Morley JE. Medical care in the nursing home. Med Clin North Am 2011; 95: 595-614, xi.
12. Cherubini A, Eusebi P, Dell'aquila G etal. Predictors of hospitalization in Italian nursing home residents: the U.L.I.S.S.E. project. J Am Med Dir Assoc 2012; 13: e5-10.
13. Morley JE, Rolland Y, Tolson D, Vellas B. The time has come to enhance nursing home care. Arch Gerontol Geriatr 2011; 53: 1-2.
14. Ouslander JG, Lamb G, Perloe M etal. Potentially avoidable hospitalizations of nursing home residents: frequency, causes, and costs: [see editorial comments by Drs. Jean F. Wyman and William R. Hazzard, pp 760-761]. J Am Geriatr Soc 2010; 58: 627-635.
15. Katz PR, Karuza J, Intrator O, Mor V. Nursing home physician specialists: a response to the workforce crisis in long-term care. Ann Intern Med 2009; 150: 411-413.
16. Loeb M, Carusone SC, Goeree R etal. Effect of a clinical pathway to reduce hospitalizations in nursing home residents with pneumonia: a randomized controlled trial. JAMA 2006; 295: 2503-2510.
17. Montalto M. Hospital in the nursing home. Treating acute hospital problems in nursing home residents using a Hospital in the Home model. Aust Fam Physician 2001; 30: 1010-1012.
18. Naughton BJ, Mylotte JM, Ramadan F, Karuza J, Priore RL. Antibiotic use, hospital admissions, and mortality before and after implementing guidelines for nursing home-acquired pneumonia. J Am Geriatr Soc 2001; 49: 1020-1024.
19. Shanley C, Whitmore E, Conforti D, Masso J, Jayasinghe S, Griffiths R. Decisions about transferring nursing home residents to hospital: highlighting the roles of advance care planning and support from local hospital and community health services. J Clin Nurs 2011; 20: 2897-2906.
20. Davidson KM. Evidence-based practice guideline family preparedness and end-of-life support before the death of a nursing home resident. J Gerontol Nurs 2011; Feb; 37 (2): 11-16.
21. Young Y, Barhydt NR, Broderick S, Colello AD, Hannan EL. Factors associated with potentially preventable hospitalization in nursing home residents in New York State: a survey of directors of nursing. J Am Geriatr Soc 2010; 58: 901-907.
22. Buchanan JL, Murkofsky RL, O'Malley AJ etal. Nursing home capabilities and decisions to hospitalize: a survey of medical directors and directors of nursing. J Am Geriatr Soc 2006; 54: 458-465.
23. Caplan GA, Meller A, Squires B, Chan S, Willett W. Advance care planning and hospital in the nursing home. Age Ageing 2006; 35: 581-585.
24. Bottrell MM, O'Sullivan JF, Robbins MA, Mitty EL, Mezey MD. Transferring dying nursing home residents to the hospital: DON perspectives on the nurse's role in transfer decisions. Geriatr Nurs 2001; 22: 313-317.
25. Jett KF. Examining the evidence: knowing if and when to transfer a resident with pneumonia from the nursing home to the hospital or subacute unit. Geriatr Nurs 2006; 27: 280.
26. Konings JW, Danse JA, Wendte JF, Ribbe MW. [Hospital admission of nursing home patients considered but not carried out: role of the nursing home physician and the involved parties and various differences with realized hospital admissions]. Tijdschr Gerontol Geriatr 1996; Oct; 27 (5): 197-205.
27. Studdert DM, Spittal MJ, Mello MM, O'Malley AJ, Stevenson DG. Relationship between quality of care and negligence litigation in nursing homes. N Engl J Med 2011; 364: 1243-1250.
28. Takezako Y, Tamiya N, Kajii E. The nursing home versus the hospital as the place of dying for nursing home residents in Japan. Health Policy 2007; May; 81 (2-3): 280-288.
29. Wong RY. Transferring nursing home residents to acute care hospital - to do or not to do, that is the question. J Am Med Dir Assoc 2010; 11: 304-305.
30. Upshur R, Nelson S. Duty to care: acknowledging complexity and uncertainty. Nurs Inq 2008; 15: 261-262.
31. Hewson MG, Kindy PJ, Van Kirk J, Gennis VA, Day RP. Strategies for managing uncertainty and complexity. J Gen Intern Med 1996; 11: 481-485.
32. Corroon-Sweeney E, Murphy C, Collins DR. Caring for nursing home patients - a primary care perspective. Ir Med J 2009; Nov-Dec; 102 (10): 317-320.
33. Lawhorne LW. Managing laboratory results in the nursing home setting: looking for Waldo or seeking wisdom. J Am Med Dir Assoc 2009; 10: 153-154.
34. Dharmarajan TS, Narayanan SL, Ali R, Ahmed S. Appropriateness of laboratory testing in nursing home elderly with advanced dementia: an opinion poll among physicians. J Am Med Dir Assoc 2000; 1: 279-281.
35. Glynn N, Bennett K, Silke B. Emergency medical readmission: long-term trends and impact on mortality. Clin Med 2011; 11: 114-118.
36. Byrne DG, Chung SL, Bennett K, Silke B. Age and outcome in acute emergency medical admissions. Age Ageing 2010; 39: 694-698.
37. Silke B, Kellett J, Rooney T, Bennett K, O'Riordan D. An improved medical admissions risk system using multivariable fractional polynomial logistic regression modelling. QJM 2010; Jan; 103 (1): 23-32.
38. O'Loughlin R, Allwright S, Barry J, Kelly A, Teljeur C. Using HIPE data as a research and planning tool: limitations and opportunities. Ir J Med Sci 2005; Apr-Jun; 174 (2): 40-45; discussion 52-7.
39. Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis 1987; 40: 373-383.
40. Wikipedia. Major diagnostic category. 2011 [Updated 2011; cited 10 Sep 2011.] Available from URL: http://en.wikipedia.org/wiki/Major_Diagnostic_Category
41. Beier K, Eppanapally S, Bazick HS etal. Elevation of blood urea nitrogen is predictive of long-term mortality in critically ill patients independent of "normal" creatinine. Crit Care Med 2011; 39: 305-313.
42. Saygitov RT, Glezer MG, Semakina SV. Blood urea nitrogen and creatinine levels at admission for mortality risk assessment in patients with acute coronary syndromes. Emerg Med J 2010; 27: 105-109.
43. Abbott. BUN/UREA. 2011 [updated 2011; cited 21 Jan 2012.] Available from URL: http://www.abbottpointofcare.com/International-and-Distributor-Info/Cartridge-and-Test-Info-Sheets.aspx
44. Patil H, Vaidya O, Bogart D. A review of causes and systemic approach to cardiac troponin elevation. Clin Cardiol 2011; 34: 723-728.
45. Waxman DA, Hecht S, Schappert J, Husk G. A model for troponin I as a quantitative predictor of in-hospital mortality. J Am Coll Cardiol 2006; 48: 1755-1762.
46. Ranhoff AH, Linnsund JM. [When should nursing home residents be transferred to hospital?]. Tidsskr Nor Laegeforen 2005; 125: 1844-1847.
47. Bergman H, Clarfield AM. Appropriateness of patient transfer from a nursing home to an acute-care hospital: a study of emergency room visits and hospital admissions. J Am Geriatr Soc 1991; 39: 1164-1168.
48. Arendts G, Dickson C, Howard K, Quine S. Transfer from residential aged care to emergency departments: an analysis of patient outcomes. Intern Med J 2012; 10: 75-82.
49. Graverholt B, Riise T, Jamtvedt G, Ranhoff AH, Kruger K, Nortvedt MW. Acute hospital admissions among nursing home residents: a population-based observational study. BMC Health Serv Res 2011; May 26; 11 (1): 126.
50. Dosa D. Should I hospitalize my resident with nursing home-acquired pneumonia? J Am Med Dir Assoc 2006; Mar; 7 (3 Suppl): S74-S80, 73.
51. Specht-Leible N, Bender M, Oster P. [Causes for in-hospital treatment of nursing home residents]. Z Gerontol Geriatr 2003; 36: 274-279.
52. Barba R, Zapatero A, Marco J etal. Admission of nursing home residents to a hospital internal medicine department. J Am Med Dir Assoc 2012; 13: 82.e13-17.
53. Ouslander JG, Diaz S, Hain D, Tappen R. Frequency and diagnoses associated with 7- and 30-day readmission of skilled nursing facility patients to a nonteaching community hospital. J Am Med Dir Assoc 2011; 12: 195-203.
54. Inzitari M, Espinosa Serralta L, Perez Bocanegra MC, Roque Figuls M, Argimon Pallas JM, Farre Calpe J. [Intermediate hospital care for subacute elderly patients as an alternative to prolonged acute hospitalization.]. Gac Sanit 2011. doi: 10.1016/j.gaceta.2011.07.007
55. O'Neill D, O'Keeffe S. Health care for older people in Ireland. J Am Geriatr Soc 2003; 51: 1280-1286.
56. Schmidt WP, Berger K, Taeger D, Lay M, Bucker-Nott HJ, Kolominsky-Rabas P. [Influence of institutional factors in neurological, medical and geriatric departments on length of stay in patients with stroke]. Dtsch Med Wochenschr 2003; 128: 979-983.
57. Goldstein RL, Campion EW, Mulley AG, Thibault GE. Nursing home patients admitted to a medical intensive care unit. Med Care 1984; 22: 854-862.
58. Ahmed AA, Hays CI, Liu B etal. Predictors of in-hospital mortality among hospitalized nursing home residents: an analysis of the National Hospital Discharge Surveys 2005-2006. J Am Med Dir Assoc 2010; Jan; 11 (1): 52-58.
59. Levy CR, Eilertsen T, Kramer AM, Hutt E. Which clinical indicators and resident characteristics are associated with health care practitioner nursing home visits or hospital transfer for urinary tract infections? J Am Med Dir Assoc 2006; 7: 493-498.