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Predictive factors for early unplanned rehospitalization of older adults after an ED visit: role of the caregiver burden

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Abstract

Background and aims

For older adults, an Emergency Department (ED) visit represents a period of vulnerability that extends beyond the visit itself. This study aimed to determine the impact of the role of caregiver, and geriatric conditions of patients on early unplanned rehospitalization (EUR) within 3 months after an ED visit.

Methods

This prospective longitudinal experimental study included consecutively 173 patients aged 75 and older admitted in an ED over a 2-week period (18.7 % of the total visits). Only older patients having a caregiver were analyzed (78.0 %, n = 135). Medical conditions and a comprehensive geriatric assessment were recorded for each patient. All caregivers were interviewed about their tasks and emotional impact using the short Zarit Burden Inventory. Three months after, patients or their caregivers were called about the vital status, and EUR of patients.

Results

Among the patients included, 64.2 % had an EUR and 28.9 % of their caregivers reported a high level of burden. EUR was strongly associated with a high caregiver burden (OR 8.7, 95 % CI 1.5–49.8). No association was found for patient’s medical or geriatric status. Caregivers reported a significantly high burden when patients were malnourished, or were at risk of adverse health outcomes based on the ISAR scale, and when they had greater disabilities in IADLs and ADLs, or cognitive impairments.

Conclusions

Many hospital readmissions after an ED visit may be preventable by identifying caregiver’s high burden. Reasons that lead to this high burden should be checked at the first visit.

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Conflicts of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Ethical standards

This study involved human participants and has been approved by two national ethics committees, the Advisory Committee on Health Research Information (“Comité Consultatif sur le Traitement de l’Information en matière de Recherche dans le domaine de la Santé”) and the National Commission on Informatics and Freedom (“Commission Nationale Informatique et Liberté”) and performed in accordance with ethical standards.

Informed consent

All patients and their caregiver signed informed consent before inclusion to the procedure.

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Authors and Affiliations

  1. Service de Médecine Interne Gériatrie, Hôpitaux Sud, Assistance Publique Hôpitaux de Marseille, Marseille, France

    Sylvie Bonin-Guillaume

  2. Institut des Neurosciences Timone, UMR-CNRS 7289, Aix-Marseille Université, Marseille, France

    Sylvie Bonin-Guillaume

  3. Laboratoire de Santé Publique, EA 3279, Faculté de Médecine, Aix-Marseille Université, Marseille, France

    Anne-Claire Durand, Fadila Yahi, Marielle Curiel-Berruyer, Roland Sambuc & Stephanie Gentile

  4. Unité Mobile de Gériatrie, Hôpital La Timone Adultes, Assistance Publique Hôpitaux de Marseille, Marseille, France

    Oceana Lacroix & Elodie Cretel

  5. Service d’Accueil des Urgences, Assistance Publique Hôpitaux de Marseille, Marseille, France

    Marc Alazia

Authors
  1. Sylvie Bonin-Guillaume
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  2. Anne-Claire Durand
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  3. Fadila Yahi
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  4. Marielle Curiel-Berruyer
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  5. Oceana Lacroix
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  6. Elodie Cretel
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  7. Marc Alazia
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  8. Roland Sambuc
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  9. Stephanie Gentile
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Corresponding author

Correspondence to Anne-Claire Durand.

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Bonin-Guillaume, S., Durand, AC., Yahi, F. et al. Predictive factors for early unplanned rehospitalization of older adults after an ED visit: role of the caregiver burden. Aging Clin Exp Res 27, 883–891 (2015). https://doi.org/10.1007/s40520-015-0347-y

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  • DOI: https://doi.org/10.1007/s40520-015-0347-y

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