Health-related quality of life at hospital discharge as a predictor for 6-month unplanned readmission and all-cause mortality of acutely admitted older medical patients.

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  • Additional Information
    • Source:
      Publisher: Springer Netherlands Country of Publication: Netherlands NLM ID: 9210257 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1573-2649 (Electronic) Linking ISSN: 09629343 NLM ISO Abbreviation: Qual Life Res Subsets: MEDLINE
    • Publication Information:
      Publication: 2005- : Netherlands : Springer Netherlands
      Original Publication: Oxford, UK : Rapid Communications of Oxford, Ltd, c1992-
    • Subject Terms:
      Mortality*; Patient Discharge/*statistics & numerical data ; Patient Readmission/*statistics & numerical data ; Quality of Life/*psychology; Aged ; Aged, 80 and over ; Denmark ; Female ; Hospitalization ; Humans ; Male ; Proportional Hazards Models ; Risk Factors
    • Abstract:
      Purpose: To assess whether health-related quality of life (HRQOL) status, using the European Quality of life-5 dimensions (EQ5D), in acutely admitted older medical patients was associated with a combined end-point including first unplanned readmission or death without prior readmission within 6 months. Secondly, to assess if HRQOL was associated with death regardless of previous readmissions.
      Methods: Patients from seven medical and two acute medical units were included and the EQ5D was obtained at discharge. Associations were assessed using Cox regression. Harrell's C-statistics indicated the predictive performance.
      Results: 1328 patients were included, 50% (n = 664) were readmitted (n = 635) or had died without prior readmission (n = 29) within 6 months. In total, 15.2% (n = 202) died within 6 months. In the gender- and age-adjusted analysis, a lower EQ5D index score was associated with a higher hazard ratio (HR) of unplanned readmission or death without prior readmission for all categories of scores below 1 (< 1 to 0.741, < 0.741 to 0.438 and < 0.438 to - 0.40), HR 1.60, 1.93 and 2.02. Likewise, a lower EQ5D score was associated with a higher HR of death, HR 1.72, 2.54 and 3.79. Harrell's C values were 0.56 and 0.63.
      Conclusion: HRQOL measured at discharge may identify acutely admitted older medical patients at especially high risk of readmission or death up to 6 months after discharge. Incorporating assessment of HRQOL should be considered when risk stratifying a heterogeneous population of acutely admitted older medical patients.
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    • Grant Information:
      13-12-2013 the Danish Development and Research Fund.
    • Contributed Indexing:
      Keywords: Cohort study; Denmark; EQ5D; Health-related quality of life; Older medical in-patients; Readmission or mortality
    • Publication Date:
      Date Created: 20190805 Date Completed: 20191226 Latest Revision: 20191226
    • Publication Date:
      20250114
    • Accession Number:
      10.1007/s11136-019-02259-w
    • Accession Number:
      31377940