A prospective study of acute illness in the nursing home

被引:0
|
作者
C. A. Alessi
J. O. Harker
机构
[1] Veterans Affairs Medical Center,Geriatric Research, Education and Clinical Center
[2] University of California,Multicampus Program in Geriatric Medicine and Gerontology
关键词
Acute illness; elderly; hospitalization; mortality; nursing homes;
D O I
暂无
中图分类号
学科分类号
摘要
Managing acute illness is an important aspect of medical care for nursing home residents, but little data is available on the nature of acute illness in this setting. The aims of this study were to determine the incidence, etiologies, risk factors and outcomes of acute illness in nursing home residents. This was a prospective cohort study of residents at one Veterans Administration nursing home (N=140). Acute illness episodes were identified prospectively for one year through staff interviews and medical record review. Etiologies of acute illness were determined based on standardized criteria. Subjects were followed for three years to determine hospital utilization, discharge location and survival. There were 113 acute illness episodes identified (0.59 episodes per subject per month). The most common etiologies were pneumonia (33% of episodes), and urinary tract infection (27%). Significant risk factors for acute illness included anemia, dependence in mobility and surveillance time (i.e., duration of time monitored for illness episodes) in the nursing home (model χ2 27.16, p<0.001). Subjects who developed acute illness had increased hospital utilization during the first year of follow-up (p=0.034); they were also less likely to be discharged home by both one year (χ2 12.37, p<0.001) and two years of follow-up (χ2 9.45, p=0.009). When hospice and respite residents with short stay were excluded, subjects who developed acute illness had lower 3-year survival (Log rank 4.97, p=0.026), and the rate of acute illness episodes (i.e., number per month monitored) predicted 3-year mortality (Cox proportional hazards, p<0.001). In conclusion, acute illness is extremely common among nursing home residents, and is most often due to infection. The occurrence of acute illness identifies residents who have increased hospital utilization, are less likely to return home, and have decreased long-term survival.
引用
收藏
页码:479 / 489
页数:10
相关论文
共 50 条
  • [41] State Regulations for Nursing Home Residents with Serious Mental Illness
    Debra Street
    Victor Molinari
    Donna Cohen
    Community Mental Health Journal, 2013, 49 : 389 - 395
  • [42] HOME TREATMENT FOR ACUTE PSYCHIATRIC-ILLNESS
    TURNER, T
    BRITISH MEDICAL JOURNAL, 1991, 302 (6767): : 49 - 49
  • [43] Acute childhood illness at home: the parents' perspective
    Neill, SJ
    JOURNAL OF ADVANCED NURSING, 2000, 31 (04) : 821 - 832
  • [44] HOME TREATMENT FOR ACUTE PSYCHIATRIC-ILLNESS
    HAWLEY, CJ
    BRITISH MEDICAL JOURNAL, 1990, 301 (6763): : 1278 - 1278
  • [45] How Many Nursing Home Residents Live With a Mental Illness?
    Bagchi, Ann D.
    Verdier, James M.
    Simon, Samuel E.
    PSYCHIATRIC SERVICES, 2009, 60 (07) : 958 - 964
  • [46] Serious Mental Illness in the Nursing Home Literature: A Scoping Review
    Bucy, Taylor
    Moeller, Kelly
    Bowblis, John R.
    Shippee, Nathan
    Fashaw-Walters, Shekinah
    Winkelman, Tyler
    Shippee, Tetyana
    GERONTOLOGY AND GERIATRIC MEDICINE, 2022, 8
  • [47] State Regulations for Nursing Home Residents with Serious Mental Illness
    Street, Debra
    Molinari, Victor
    Cohen, Donna
    COMMUNITY MENTAL HEALTH JOURNAL, 2013, 49 (04) : 389 - 395
  • [48] MENTAL-ILLNESS AMONG NURSING-HOME PATIENTS
    ROVNER, BW
    RABINS, PV
    HOSPITAL AND COMMUNITY PSYCHIATRY, 1985, 36 (02): : 119 - &
  • [49] HOME TREATMENT FOR ACUTE PSYCHIATRIC-ILLNESS
    DEAN, C
    GADD, EM
    BRITISH MEDICAL JOURNAL, 1990, 301 (6759): : 1021 - 1023
  • [50] The Nursing Home Crisis: A Consumer Study of Texas Nursing Home Care
    Greene, Roberta R.
    Graham, Sandra A.
    Haulotte, Shirley M.
    Nixon-Garcia, Caroline
    Gleason-Wynn, Patricia
    JOURNAL OF GERONTOLOGICAL SOCIAL WORK, 2005, 45 (04): : 101 - 123