TY - JOUR
T1 - Risk factors for in-hospital mortality in patients with dementia
AU - Golüke, Nienke M S
AU - van de Vorst, Irene E
AU - Vaartjes, Ilonca H
AU - Geerlings, Mirjam I
AU - de Jonghe, Annemarieke
AU - Bots, Michiel L
AU - Koek, Huiberdina L
N1 - Funding Information:
This study was supported by Alzheimer Nederland (project no WE.03-2012-38) and by a grant from the Netherlands Heart Foundation (grant number 31653251 ) as part of the project ‘Cardiovascular disease in the Netherlands: figures and facts’ of the Netherlands Heart Foundation. The sponsors had no role in the design, conduct, writing or interpretation of the results.
Publisher Copyright:
© 2019 Elsevier B.V.
PY - 2019/11
Y1 - 2019/11
N2 - OBJECTIVE: To examine the in-hospital mortality rate, and its risk factors, for patients with dementia admitted to hospital.STUDY DESIGN: We constructed an observational cohort study through data linkage of three Dutch national registers: the hospital discharge register (HDR), the population register (PR) and the national cause of death register. Patients with dementia in the HDR aged between 60 and 100 years registered between 1 January 2000 and 31 December 2010 were included.MAIN OUTCOME MEASURES: Risk factors for in-hospital mortality were investigated using multivariable Cox proportional hazard regression models that included sex, age, marital status, ethnicity, somatic comorbidity, type of dementia and urgency of admission.RESULTS: 40,500 patients were included in the cohort. The overall in-hospital mortality rate was 11.1%. Factors that significantly increased the mortality risk were: male sex (adjusted hazard ratio (HR) 1.52, 95%-confidence interval (95%-CI) 1.43-1.63), higher age (adjusted HR 1.03, 95%-CI 1.03-1.04), living with a partner (adjusted HR 1.39, 95%-CI 1.30-1.49), acute admission (adjusted HR 2.16, 95%-CI 1.97-2.36) and Alzheimer's disease (adjusted HR 1.21, 95%-CI 1.13-1.29). Cardiovascular disease was the most common cause of in-hospital mortality.CONCLUSIONS: This nationwide study found several independent risk factors for the in-hospital mortality of patients with dementia, including male sex, higher age, living with a partner, acute admission, and Alzheimer's disease. These risk factors should be taken into account by clinicians and caregivers as they will indicate whether patients are at risk of a more unfavourable outcome during hospital admission.
AB - OBJECTIVE: To examine the in-hospital mortality rate, and its risk factors, for patients with dementia admitted to hospital.STUDY DESIGN: We constructed an observational cohort study through data linkage of three Dutch national registers: the hospital discharge register (HDR), the population register (PR) and the national cause of death register. Patients with dementia in the HDR aged between 60 and 100 years registered between 1 January 2000 and 31 December 2010 were included.MAIN OUTCOME MEASURES: Risk factors for in-hospital mortality were investigated using multivariable Cox proportional hazard regression models that included sex, age, marital status, ethnicity, somatic comorbidity, type of dementia and urgency of admission.RESULTS: 40,500 patients were included in the cohort. The overall in-hospital mortality rate was 11.1%. Factors that significantly increased the mortality risk were: male sex (adjusted hazard ratio (HR) 1.52, 95%-confidence interval (95%-CI) 1.43-1.63), higher age (adjusted HR 1.03, 95%-CI 1.03-1.04), living with a partner (adjusted HR 1.39, 95%-CI 1.30-1.49), acute admission (adjusted HR 2.16, 95%-CI 1.97-2.36) and Alzheimer's disease (adjusted HR 1.21, 95%-CI 1.13-1.29). Cardiovascular disease was the most common cause of in-hospital mortality.CONCLUSIONS: This nationwide study found several independent risk factors for the in-hospital mortality of patients with dementia, including male sex, higher age, living with a partner, acute admission, and Alzheimer's disease. These risk factors should be taken into account by clinicians and caregivers as they will indicate whether patients are at risk of a more unfavourable outcome during hospital admission.
KW - Dementia
KW - In-hospital mortality
KW - Older adults
KW - Prognosis
KW - Risk factors
UR - http://www.scopus.com/inward/record.url?scp=85071547601&partnerID=8YFLogxK
U2 - 10.1016/j.maturitas.2019.08.007
DO - 10.1016/j.maturitas.2019.08.007
M3 - Article
C2 - 31547914
SN - 0378-5122
VL - 129
SP - 57
EP - 61
JO - Maturitas
JF - Maturitas
ER -