Ann Geriatr Med Res.  2020 Jun;24(2):83-90. 10.4235/agmr.20.0017.

Importance of Geriatric Syndrome Screening within 48 Hours of Hospitalization for Identifying Readmission Risk: A Retrospective Study in an Acute-Care Hospital

• Shin J
• Han SH
• Choi J
• Kim YS
• Lee J

• KMID: 2503333
• DOI: http://doi.org/10.4235/agmr.20.0017

Abstract

Background
Given the association between geriatric syndrome and hospital readmission, we evaluated the suitability of geriatric syndrome screening for care (GSC) in identifying readmission risk and suggested the appropriate time for GSC.
Methods
GSC considering cognitive impairment, depression, polypharmacy (five or more medications), functional mobility, dysphagia, malnutrition, pain, and incontinence was performed among 2,663 general ward inpatients aged 65 years or older within 48 hours after admission and again before discharge between November 2016 and October 2017. Each patient’s history of falls, pressure ulcers, potentially inappropriate medication use, and delirium was assessed at admission. Patients were divided into two groups on the basis of readmission within 1 year after the first admission. According to the screening period (at admission and before discharge) and in-hospital decline, we applied receiver operating characteristic curve analysis to compare the prevalence of clinical concerns between the readmission and no-readmission groups. We also used multiple logistic regression analysis to evaluate the risk of readmission according to the presence of geriatric syndrome and clinical outcomes.
Results
The 782 readmitted patients (29.4%) showed a higher rate of poor GSC than those who were not readmitted. Polypharmacy at admission was significantly correlated with readmission risk (area under the receiver operating characteristic curve=0.602). Fall history (odds ratio [OR]=4.36; 95% confidence interval [CI], 2.36–8.05), urinary incontinence (OR=4.21; 95% CI, 3.28–5.39), and depressive mood (OR=3.88; 95% CI, 2.69–5.59) at admission were risk factors for readmission.
Conclusion
GSC at admission was associated with readmission risk compared with GSC before discharge or monitoring for in-hospital decline.

Keyword

Patient readmission; Aged; Geriatric assessment; Risk assessment