Skip to main content
Mijn bibliotheek
Shop
Nieuws Boeken Tijdschriften E-learning Web-tv Video Audio
Tips voor Mijn BSL
UITGEBREID ZOEKEN
Inloggen
Top
Quality of Life Research
Gepubliceerd in: Quality of Life Research 11/2019

03-08-2019

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

Auteurs: Jane Andreasen, Robbert J. J. Gobbens, Helle Højmark Eriksen, Kim Overvad

Gepubliceerd in: Quality of Life Research | Uitgave 11/2019

Log in om toegang te krijgen
share
DELEN

Deel dit onderdeel of sectie (kopieer de link)

  • Optie A:
    Klik op de rechtermuisknop op de link en selecteer de optie “linkadres kopiëren”
  • Optie B:
    Deel de link per e-mail
    Link delen
publish
Publiceer nu

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.
vorige artikel Correspondence of directly reported and recalled health-related quality of life in a large heterogeneous sample of trauma patients
volgende artikel The link between sexual satisfaction and subjective well-being: a longitudinal perspective based on the German Ageing Survey
Literatuur
1.
OECD. (2013). OECD reviews of health care quality: Denmark 2013: Raising standards. Paris: OECD Publishing. ISBN 978-92-64-19113-6.
2.
Buurman, B. M., Frenkel, W. J., Abu-Hanna, A., Parlevliet, J. L., & de Rooij, S. E. (2016). Acute and chronic diseases as part of multimorbidity in acutely hospitalized older patients. European Journal of Internal Medicine, 27, 68–75.PubMed
3.
Gobbens, R. J. J., & van Assen, M. A. L. M. (2017). Associations between multidimensional frailty and quality of life among Dutch older people. Archives of Gerontology and Geriatrics, 73, 69–76.PubMed
4.
Lee, Y. (2000). The predictive value of self assessed general, physical, and mental health on functional decline and mortality in older adults. Journal of Epidemiology and Community Health, 54(2), 123–129.PubMedPubMedCentral
5.
Tsai, S. Y., Chi, L. Y., Lee, C. H., & Chou, P. (2007). Health-related quality of life as a predictor of mortality among community-dwelling older persons. European Journal of Epidemiology, 22(1), 19–26.PubMed
6.
Murray, C., Brett, C. E., Starr, J. M., & Deary, I. J. (2011). Which aspects of subjectively reported quality of life are important in predicting mortality beyond known risk factors? The Lothian Birth Cohort 1921 Study. Quality of Life Research: An International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation, 20(1), 81–90.
7.
Cavrini, G., Broccoli, S., Puccini, A., & Zoli, M. (2012). EQ-5D as a predictor of mortality and hospitalization in elderly people. Quality of Life Research: An International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation, 21(2), 269–280.
8.
9.
10.
Covinsky, K. E., Pierluissi, E., & Johnston, C. B. (2011). Hospitalization-associated disability:“She was probably able to ambulate, but I’m not sure”. JAMA, 306(16), 1782–1793.PubMed
11.
Krumholz, H. M. (2013). Post-hospital syndrome—an acquired, transient condition of generalized risk. New England Journal of Medicine, 368(2), 100–102.PubMed
12.
Bodilsen, A. C., Klausen, H. H., Petersen, J., Beyer, N., Andersen, O., Jorgensen, L. M., et al. (2016). Prediction of mobility limitations after hospitalization in older medical patients by simple measures of physical performance obtained at admission to the emergency department. PLoS ONE, 11(5), e0154350.PubMedPubMedCentral
13.
Andreasen, J., Aadahl, M., Sorensen, E. E., Eriksen, H. H., Lund, H., & Overvad, K. (2018). Associations and predictions of readmission or death in acutely admitted older medical patients using self-reported frailty and functional measures. A Danish cohort study. Archives of Gerontology and Geriatrics, 76, 65–72.PubMed
14.
Smolin, B., Levy, Y., Sabbach-Cohen, E., Levi, L., & Mashiach, T. (2015). Predicting mortality of elderly patients acutely admitted to the Department of Internal Medicine. International Journal of Clinical Practice, 69(4), 501–508.PubMed
15.
Parlevliet, J. L., MacNeil-Vroomen, J., Buurman, B. M., de Rooij, S. E., & Bosmans, J. E. (2016). Health-related quality of life at admission is associated with postdischarge mortality, functional decline, and institutionalization in acutely hospitalized older medical patients. Journal of the American Geriatrics Society, 64(4), 761–768.PubMed
16.
Pearson, S., Stewart, S., & Rubenach, S. (1999). Is health-related quality of life among older, chronically ill patients associated with unplanned readmission to hospital? Australian and New Zealand Journal of Medicine, 29(5), 701–706.PubMed
17.
Belayachi, J., El Khattate, A., Bizrane, M., Madani, N., & Abouqal, R. (2018). Pre-admission quality of life as predictor of outcome after acute care: the role of emotional well-being. QJM : Monthly Journal of the Association of Physicians, 111(2), 111–115.PubMed
18.
19.
Dhaussy, G., Drame, M., Jolly, D., Mahmoudi, R., Barbe, C., Kanagaratnam, L., et al. (2012). Is health-related quality of life an independent prognostic factor for 12-month mortality and nursing home placement among elderly patients hospitalized via the emergency department? Journal of the American Medical Directors Association, 13(5), 453–458.PubMed
20.
Belga, S., Majumdar, S. R., Kahlon, S., Pederson, J., Lau, D., Padwal, R. S., et al. (2016). Comparing three different measures of frailty in medical inpatients: Multicenter prospective cohort study examining 30‐day risk of readmission or death. Journal of Hospital Medicine, 11, 556–562.PubMed
21.
Kahlon, S., Pederson, J., Majumdar, S. R., Belga, S., Lau, D., Fradette, M., et al. (2015). Association between frailty and 30-day outcomes after discharge from hospital. CMAJ: Canadian Medical Association journal = journal de l’Association medicale canadienne, 187(11), 799–804.PubMed
22.
Carpenter, C. R., Shelton, E., Fowler, S., Suffoletto, B., Platts-Mills, T. F., Rothman, R. E., et al. (2015). Risk factors and screening instruments to predict adverse outcomes for undifferentiated older emergency department patients: A systematic review and meta-analysis. Academic Emergency Medicine, 22(1), 1–21.PubMed
23.
Garcia-Perez, L., Linertova, R., Lorenzo-Riera, A., Vazquez-Diaz, J. R., Duque-Gonzalez, B., & Sarria-Santamera, A. (2011). Risk factors for hospital readmissions in elderly patients: A systematic review. QJM: Monthly Journal of the Association of Physicians, 104(8), 639–651.PubMed
24.
Kansagara, D., Englander, H., Salanitro, A., Kagen, D., Theobald, C., Freeman, M., et al. (2011). Risk prediction models for hospital readmission. JAMA: The Journal of the American Medical Association, 306(15), 1688–1698.PubMed
25.
Romero-Ortuno, R., Forsyth, D. R., Wilson, K. J., Cameron, E., Wallis, S., Biram, R., et al. (2017). The association of geriatric syndromes with hospital outcomes. Journal of Hospital Medicine, 12(2), 83–89.PubMed
26.
Wou, F., Gladman, J. R., Bradshaw, L., Franklin, M., Edmans, J., & Conroy, S. P. (2013). The predictive properties of frailty-rating scales in the acute medical unit. Age and Ageing, 42(6), 776–781.PubMedPubMedCentral
27.
Pilotto, A., Rengo, F., Marchionni, N., Sancarlo, D., Fontana, A., Panza, F., et al. (2012). Comparing the prognostic accuracy for all-cause mortality of frailty instruments: a multicentre 1-year follow-up in hospitalized older patients. PLoS ONE, 7(1), e29090.PubMedPubMedCentral
28.
Woo, J., Leung, J., & Morley, J. E. (2012). Comparison of frailty indicators based on clinical phenotype and the multiple deficit approach in predicting mortality and physical limitation. Journal of the American Geriatrics Society, 60(8), 1478–1486.PubMed
29.
Dent, E., Chapman, I., Howell, S., Piantadosi, C., & Visvanathan, R. (2014). Frailty and functional decline indices predict poor outcomes in hospitalised older people. Age and Ageing, 43(4), 477–484.PubMed
30.
31.
Brooks, R. (1996). EuroQol: The current state of play. Health Policy (Amsterdam, Netherlands), 37(1), 53–72.
32.
Sorensen, J., Davidsen, M., Gudex, C., Pedersen, K. M., & Bronnum-Hansen, H. (2009). Danish EQ-5D population norms. Scandinavian Journal of Public Health, 37(5), 467–474.PubMed
33.
Von Elm, E., Altman, D. G., Egger, M., Pocock, S. J., Gøtzsche, P. C., Vandenbroucke, J. P., et al. (2007). The strengthening the reporting of observational studies in epidemiology (STROBE) statement: Guidelines for reporting observational studies. Preventive Medicine, 45(4), 247–251.
34.
Olejaz, M., Juul Nielsen, A., Rudkjobing, A., Okkels Birk, H., Krasnik, A., & Hernández-Quevedo, C. (2012). Denmark: Health system review. Health systems in transition. Copenhagen: World Health Organization.
35.
Erkinjuntti, T., Sulkava, R., Wikstrom, J., & Autio, L. (1987). Short potable mental status questionnaire as a screening test for dementia and delirium among the elderly. Journal of the American Geriatric Society, 35(5), 412–416.
36.
Foreman, M. D. (1987). Reliability and validity of mental status questionnaires in elderly hospitalized patients. Nursing Research, 36(4), 216–220.PubMed
37.
Brooks, R. (1996). EuroQol: The current state of play. Health Policy, 37, 53–72.PubMed
38.
Wittrup-Jensen, K. U., Lauridsen, J., Gudex, C., & Pedersen, K. M. (2009). Generation of a Danish TTO value set for EQ-5D health states. Scandinavian Journal of Public Health, 37(5), 459–466.PubMed
39.
Walters, S. J., & Brazier, J. E. (2005). Comparison of the minimally important difference for two health state utility measures: EQ-5D and SF-6D. Quality of Life Research: An International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation, 14(6), 1523–1532.
40.
Needham, D. M., Scales, D. C., Laupacis, A., & Pronovost, P. J. (2005). A systematic review of the Charlson comorbidity index using Canadian administrative databases: A perspective on risk adjustment in critical care research. Journal of Critical Care, 20(1), 12–19.PubMed
41.
Clark, T. G., Bradburn, M. J., Love, S. B., & Altman, D. G. (2003). Survival analysis part I: Basic concepts and first analyses. British Journal of Cancer, 89(2), 232–238.PubMedPubMedCentral
42.
Bradburn, M. J., Clark, T. G., Love, S. B., & Altman, D. G. (2003). Survival analysis part II: Multivariate data analysis-an introduction to concepts and methods. British Journal of Cancer, 89(3), 431–436.PubMedPubMedCentral
43.
Crowther, M. J., & Lambert, P. C. (2014). A general framework for parametric survival analysis. Statistics in Medicine, 33(30), 5280–5297.PubMed
44.
Warnier, R. M. J., van Rossum, E., van Kuijk, S. M. J., Mulder, W. J., Schols, J. M. G. A., & Kempen, G. I. J. M. (2017). The Maastricht frailty screening tool for hospitalised patients (MFST-HP) to identify non-frail patients. International Journal of Clinical Practice. https://​doi.​org/​10.​1111/​ijcp.​13003.CrossRefPubMed
45.
Pijpers, E., Ferreira, I., Stehouwer, C. D., & Nieuwenhuijzen Kruseman, A. C. (2012). The frailty dilemma. Review of the predictive accuracy of major frailty scores. European Journal of Internal Medicine, 23(2), 118–123.PubMed
46.
47.
Finch, A. P., Brazier, J. E., & Mukuria, C. (2018). What is the evidence for the performance of generic preference-based measures? A systematic overview of reviews. The European Journal of Health Economics: HEPAC: Health Economics in Prevention and Care, 19(4), 557–570.PubMed
Metagegevens
Titel
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
Auteurs
Jane Andreasen
Robbert J. J. Gobbens
Helle Højmark Eriksen
Kim Overvad
Publicatiedatum
03-08-2019
Uitgeverij
Springer International Publishing
Gepubliceerd in
Quality of Life Research / Uitgave 11/2019
Print ISSN: 0962-9343
Elektronisch ISSN: 1573-2649
DOI
https://doi.org/10.1007/s11136-019-02259-w

Andere artikelen Uitgave 11/2019

Quality of Life Research 11/2019 Naar de uitgave

OriginalPaper

Impact of comorbidities and functional impairment on 5-year loss of health utility in patients with lower-limb osteoarthritis in the KHOALA cohort

OriginalPaper

Patient-reported outcomes as predictors of survival in patients with bowel cancer: a systematic review

OriginalPaper

Association between Type D personality and outcomes in patients with non-ischemic heart failure

OriginalPaper

Prevalence of anxiety in patients with an implantable cardioverter defibrillator: measurement equivalence of the HADS-A and the STAI-S

OriginalPaper

Exploring the patient experience of locally advanced or metastatic pancreatic cancer to inform patient-reported outcomes assessment

Review

The effect of whole body vibration on health-related quality of life in patients with chronic conditions: a systematic review