Dementia and the risk of short-term readmission and mortality after a pneumonia admission
At time of discharge after a pneumonia admission, care planning for older persons with dementia is essential. However, care planning is limited by lack of knowledge on the short-term prognosis. To investigate 30-day mortality and readmission after hospital discharge for pneumonia in persons with ver...
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| creator | Graversen, Susanne Boel Pedersen, Henrik Schou Sandbaek, Annelli Foss, Catherine Hauerslev Palmer, Victoria Jane Ribe, Anette Riisgaard |
| description | At time of discharge after a pneumonia admission, care planning for older persons with dementia is essential. However, care planning is limited by lack of knowledge on the short-term prognosis.
To investigate 30-day mortality and readmission after hospital discharge for pneumonia in persons with versus without dementia, and to investigate how these associations vary with age, time since discharge, and medication use.
Using the Danish registries, we investigated 30-day mortality and readmission in persons (+65 years) discharged after pneumonia in 2000-2016 (N = 298,872). Adjusted mortality rate ratios (aMRRs) and incidence rate ratios (aIRRs) were calculated for persons with versus without dementia, and we investigated if these associations varied with use of benzodiazepines, opioids, and antipsychotics, and with age and time since discharge.
Among 25,948 persons with dementia, 4,524 died and 5,694 were readmitted within 30 days. The risk of 30-day mortality was 129% higher (95% CI 2.21-2.37) in persons with versus without dementia after adjustment for sociodemographic characteristics, admission-related factors, and comorbidities. Further, the highest mortality risk was found in persons with both dementia and use of antipsychotics (aMRR: 3.39, 95% CI 3.19-3.59); 16% of deaths in this group could not be explained by the independent effect of each exposure. In those with dementia, the highest aMRRs were found for the youngest and for the first days after discharge. The risk of 30-day readmission was 7% higher (95% CI 1.04-1.10) in persons with versus without dementia. In those with dementia, the highest aIRRs were found for the first days after discharge.
Dementia was associated with higher short-term mortality after pneumonia, especially in users of antipsychotics, and with slightly higher readmission, especially in the first days after discharge. This is essential knowledge in the care planning for persons with dementia who are discharged after a pneumonia admission. |
| doi_str_mv | 10.1371/journal.pone.0246153 |
| format | Article |
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To investigate 30-day mortality and readmission after hospital discharge for pneumonia in persons with versus without dementia, and to investigate how these associations vary with age, time since discharge, and medication use.
Using the Danish registries, we investigated 30-day mortality and readmission in persons (+65 years) discharged after pneumonia in 2000-2016 (N = 298,872). Adjusted mortality rate ratios (aMRRs) and incidence rate ratios (aIRRs) were calculated for persons with versus without dementia, and we investigated if these associations varied with use of benzodiazepines, opioids, and antipsychotics, and with age and time since discharge.
Among 25,948 persons with dementia, 4,524 died and 5,694 were readmitted within 30 days. The risk of 30-day mortality was 129% higher (95% CI 2.21-2.37) in persons with versus without dementia after adjustment for sociodemographic characteristics, admission-related factors, and comorbidities. Further, the highest mortality risk was found in persons with both dementia and use of antipsychotics (aMRR: 3.39, 95% CI 3.19-3.59); 16% of deaths in this group could not be explained by the independent effect of each exposure. In those with dementia, the highest aMRRs were found for the youngest and for the first days after discharge. The risk of 30-day readmission was 7% higher (95% CI 1.04-1.10) in persons with versus without dementia. In those with dementia, the highest aIRRs were found for the first days after discharge.
Dementia was associated with higher short-term mortality after pneumonia, especially in users of antipsychotics, and with slightly higher readmission, especially in the first days after discharge. This is essential knowledge in the care planning for persons with dementia who are discharged after a pneumonia admission.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0246153</identifier><identifier>PMID: 33507947</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Age ; Aged patients ; Anesthesia ; Antipsychotics ; Bacterial pneumonia ; Benzodiazepines ; Biology and Life Sciences ; Cohabitation ; Comorbidity ; Data analysis ; Dementia ; Dementia disorders ; Diabetes mellitus ; Editing ; Exposure ; Geriatrics ; Health risks ; Hospital care ; Mathematical analysis ; Medicine and Health Sciences ; Methodology ; Mortality ; Narcotics ; Nursing ; Older people ; Opioids ; Patient outcomes ; People and Places ; Pneumonia ; Population ; Primary care ; Psychotropic drugs ; Public health ; Reviews ; Risk factors ; Sensitivity analysis ; Social Sciences ; Statistics ; Subgroups</subject><ispartof>PloS one, 2021-01, Vol.16 (1), p.e0246153-e0246153</ispartof><rights>COPYRIGHT 2021 Public Library of Science</rights><rights>2021 Graversen et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2021 Graversen et al 2021 Graversen et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-5425318f6aeaac02c7d9ac1748f9d67279cc5225731370f76fb4e719fc612b003</citedby><cites>FETCH-LOGICAL-c692t-5425318f6aeaac02c7d9ac1748f9d67279cc5225731370f76fb4e719fc612b003</cites><orcidid>0000-0002-3731-2521</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7842970/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7842970/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23845,27901,27902,53766,53768,79343,79344</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33507947$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Mogi, Masaki</contributor><creatorcontrib>Graversen, Susanne Boel</creatorcontrib><creatorcontrib>Pedersen, Henrik Schou</creatorcontrib><creatorcontrib>Sandbaek, Annelli</creatorcontrib><creatorcontrib>Foss, Catherine Hauerslev</creatorcontrib><creatorcontrib>Palmer, Victoria Jane</creatorcontrib><creatorcontrib>Ribe, Anette Riisgaard</creatorcontrib><title>Dementia and the risk of short-term readmission and mortality after a pneumonia admission</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>At time of discharge after a pneumonia admission, care planning for older persons with dementia is essential. However, care planning is limited by lack of knowledge on the short-term prognosis.
To investigate 30-day mortality and readmission after hospital discharge for pneumonia in persons with versus without dementia, and to investigate how these associations vary with age, time since discharge, and medication use.
Using the Danish registries, we investigated 30-day mortality and readmission in persons (+65 years) discharged after pneumonia in 2000-2016 (N = 298,872). Adjusted mortality rate ratios (aMRRs) and incidence rate ratios (aIRRs) were calculated for persons with versus without dementia, and we investigated if these associations varied with use of benzodiazepines, opioids, and antipsychotics, and with age and time since discharge.
Among 25,948 persons with dementia, 4,524 died and 5,694 were readmitted within 30 days. The risk of 30-day mortality was 129% higher (95% CI 2.21-2.37) in persons with versus without dementia after adjustment for sociodemographic characteristics, admission-related factors, and comorbidities. Further, the highest mortality risk was found in persons with both dementia and use of antipsychotics (aMRR: 3.39, 95% CI 3.19-3.59); 16% of deaths in this group could not be explained by the independent effect of each exposure. In those with dementia, the highest aMRRs were found for the youngest and for the first days after discharge. The risk of 30-day readmission was 7% higher (95% CI 1.04-1.10) in persons with versus without dementia. In those with dementia, the highest aIRRs were found for the first days after discharge.
Dementia was associated with higher short-term mortality after pneumonia, especially in users of antipsychotics, and with slightly higher readmission, especially in the first days after discharge. This is essential knowledge in the care planning for persons with dementia who are discharged after a pneumonia admission.</description><subject>Age</subject><subject>Aged patients</subject><subject>Anesthesia</subject><subject>Antipsychotics</subject><subject>Bacterial pneumonia</subject><subject>Benzodiazepines</subject><subject>Biology and Life Sciences</subject><subject>Cohabitation</subject><subject>Comorbidity</subject><subject>Data analysis</subject><subject>Dementia</subject><subject>Dementia disorders</subject><subject>Diabetes mellitus</subject><subject>Editing</subject><subject>Exposure</subject><subject>Geriatrics</subject><subject>Health risks</subject><subject>Hospital care</subject><subject>Mathematical analysis</subject><subject>Medicine and Health Sciences</subject><subject>Methodology</subject><subject>Mortality</subject><subject>Narcotics</subject><subject>Nursing</subject><subject>Older people</subject><subject>Opioids</subject><subject>Patient outcomes</subject><subject>People and Places</subject><subject>Pneumonia</subject><subject>Population</subject><subject>Primary care</subject><subject>Psychotropic drugs</subject><subject>Public health</subject><subject>Reviews</subject><subject>Risk factors</subject><subject>Sensitivity analysis</subject><subject>Social 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and the risk of short-term readmission and mortality after a pneumonia admission</title><author>Graversen, Susanne Boel ; Pedersen, Henrik Schou ; Sandbaek, Annelli ; Foss, Catherine Hauerslev ; Palmer, Victoria Jane ; Ribe, Anette Riisgaard</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c692t-5425318f6aeaac02c7d9ac1748f9d67279cc5225731370f76fb4e719fc612b003</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Age</topic><topic>Aged patients</topic><topic>Anesthesia</topic><topic>Antipsychotics</topic><topic>Bacterial pneumonia</topic><topic>Benzodiazepines</topic><topic>Biology and Life Sciences</topic><topic>Cohabitation</topic><topic>Comorbidity</topic><topic>Data analysis</topic><topic>Dementia</topic><topic>Dementia disorders</topic><topic>Diabetes mellitus</topic><topic>Editing</topic><topic>Exposure</topic><topic>Geriatrics</topic><topic>Health 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admission</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2021-01-28</date><risdate>2021</risdate><volume>16</volume><issue>1</issue><spage>e0246153</spage><epage>e0246153</epage><pages>e0246153-e0246153</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>At time of discharge after a pneumonia admission, care planning for older persons with dementia is essential. However, care planning is limited by lack of knowledge on the short-term prognosis.
To investigate 30-day mortality and readmission after hospital discharge for pneumonia in persons with versus without dementia, and to investigate how these associations vary with age, time since discharge, and medication use.
Using the Danish registries, we investigated 30-day mortality and readmission in persons (+65 years) discharged after pneumonia in 2000-2016 (N = 298,872). Adjusted mortality rate ratios (aMRRs) and incidence rate ratios (aIRRs) were calculated for persons with versus without dementia, and we investigated if these associations varied with use of benzodiazepines, opioids, and antipsychotics, and with age and time since discharge.
Among 25,948 persons with dementia, 4,524 died and 5,694 were readmitted within 30 days. The risk of 30-day mortality was 129% higher (95% CI 2.21-2.37) in persons with versus without dementia after adjustment for sociodemographic characteristics, admission-related factors, and comorbidities. Further, the highest mortality risk was found in persons with both dementia and use of antipsychotics (aMRR: 3.39, 95% CI 3.19-3.59); 16% of deaths in this group could not be explained by the independent effect of each exposure. In those with dementia, the highest aMRRs were found for the youngest and for the first days after discharge. The risk of 30-day readmission was 7% higher (95% CI 1.04-1.10) in persons with versus without dementia. In those with dementia, the highest aIRRs were found for the first days after discharge.
Dementia was associated with higher short-term mortality after pneumonia, especially in users of antipsychotics, and with slightly higher readmission, especially in the first days after discharge. This is essential knowledge in the care planning for persons with dementia who are discharged after a pneumonia admission.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>33507947</pmid><doi>10.1371/journal.pone.0246153</doi><tpages>e0246153</tpages><orcidid>https://orcid.org/0000-0002-3731-2521</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Age Aged patients Anesthesia Antipsychotics Bacterial pneumonia Benzodiazepines Biology and Life Sciences Cohabitation Comorbidity Data analysis Dementia Dementia disorders Diabetes mellitus Editing Exposure Geriatrics Health risks Hospital care Mathematical analysis Medicine and Health Sciences Methodology Mortality Narcotics Nursing Older people Opioids Patient outcomes People and Places Pneumonia Population Primary care Psychotropic drugs Public health Reviews Risk factors Sensitivity analysis Social Sciences Statistics Subgroups |
| title | Dementia and the risk of short-term readmission and mortality after a pneumonia admission |
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