In-Hospital Mortality in Patients with and without Dementia across Age Groups, Clinical Departments, and Primary Admission Diagnoses
Abstract
1. Introduction
2. Methods
2.1. Data Source
2.2. Study Population
2.3. Study Outcome
2.4. Admission Diagnoses
2.5. Statistical Analyses
3. Results
3.1. Baseline Characteristics
3.2. Prevalence of In-Hospital Mortality
3.3. Association between Dementia and In-Hospital Mortality
4. Discussion
5. Limitations
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
- Alzheimer’s Association. 2020 Alzheimer’s disease facts and figures. Alzheimers Dement. 2020, 16, 391–460. [Google Scholar] [CrossRef]
- Sommerlad, A.; Perera, G.; Mueller, C.; Singh-Manoux, A.; Lewis, G.; Stewart, R.; Livingston, G. Hospitalisation of people with dementia: Evidence from English electronic health records from 2008 to 2016. Eur. J. Epidemiol. 2019, 34, 567–577. [Google Scholar] [CrossRef]
- Sampson, E.L.; Blanchard, M.R.; Jones, L.; Tookman, A.; King, M. Dementia in the acute hospital: Prospective cohort study of prevalence and mortality. Br. J. Psychiatry 2009, 195, 61–66. [Google Scholar] [CrossRef] [PubMed]
- Bickel, H.; Hendlmeier, I.; Hessler, J.B.; Junge, M.N.; Leonhardt-Achilles, S.; Weber, J.; Schaufele, M. The Prevalence of Dementia and Cognitive Impairment in Hospitals. Dtsch. Arztebl. Int. 2018, 115, 733–740. [Google Scholar] [CrossRef]
- Zuliani, G.; Gallerani, M.; Martellucci, C.A.; Reverberi, R.; Brombo, G.; Cervellati, C.; Zuin, M.; Pistolesi, C.; Pedrini, D.; Flacco, M.E.; et al. Dementia and in-hospital mortality: Retrospective analysis of a nationwide administrative database of elderly subjects in Italy. Aging Clin. Exp. Res. 2022, 34, 1037–1045. [Google Scholar] [CrossRef] [PubMed]
- Blandi, L.; Amorosi, A.; Bertuccio, P.; Odone, A. Trends of hospital admissions and mortality of patients with dementia: Descriptive study in Lombardy. Eur. J. Public Health 2022, 32, ckac131.139. [Google Scholar] [CrossRef]
- Goluke, N.M.S.; van de Vorst, I.E.; Vaartjes, I.H.; Geerlings, M.I.; de Jonghe, A.; Bots, M.L.; Koek, H.L. Risk factors for in-hospital mortality in patients with dementia. Maturitas 2019, 129, 57–61. [Google Scholar] [CrossRef]
- Tehrani, D.M.; Darki, L.; Erande, A.; Malik, S. In-hospital mortality and coronary procedure use for individuals with dementia with acute myocardial infarction in the United States. J. Am. Geriatr. Soc. 2013, 61, 1932–1936. [Google Scholar] [CrossRef]
- De Matteis, G.; Burzo, M.L.; Della Polla, D.A.; Serra, A.; Russo, A.; Landi, F.; Gasbarrini, A.; Gambassi, G.; Franceschi, F.; Covino, M. Outcomes and Predictors of In-Hospital Mortality among Older Patients with Dementia. J. Clin. Med. 2022, 12, 59. [Google Scholar] [CrossRef]
- Kaur, P.; Kannapiran, P.; Ng, S.H.X.; Chu, J.; Low, Z.J.; Ding, Y.Y.; Tan, W.S.; Hum, A. Predicting mortality in patients diagnosed with advanced dementia presenting at an acute care hospital: The PROgnostic Model for Advanced DEmentia (PRO-MADE). BMC Geriatr. 2023, 23, 255. [Google Scholar] [CrossRef]
- Morandi, A.; Di Santo, S.G.; Zambon, A.; Mazzone, A.; Cherubini, A.; Mossello, E.; Bo, M.; Marengoni, A.; Bianchetti, A.; Cappa, S.; et al. Delirium, Dementia, and In-Hospital Mortality: The Results From the Italian Delirium Day 2016, A National Multicenter Study. J. Gerontol. A Biol. Sci. Med. Sci. 2019, 74, 910–916. [Google Scholar] [CrossRef] [PubMed]
- Houttekier, D.; Reyniers, T.; Deliens, L.; Van Den Noortgate, N.; Cohen, J. Dying in hospital with dementia and pneumonia: A nationwide study using death certificate data. Gerontology 2014, 60, 31–37. [Google Scholar] [CrossRef] [PubMed]
- Laditka, J.N.; Laditka, S.B.; Cornman, C.B. Evaluating hospital care for individuals with Alzheimer’s disease using inpatient quality indicators. Am. J. Alzheimers Dis. Other Demen. 2005, 20, 27–36. [Google Scholar] [CrossRef] [PubMed]
- Guijarro, R.; San Roman, C.M.; Gomez-Huelgas, R.; Villalobos, A.; Martin, M.; Guil, M.; Martinez-Gonzalez, M.A.; Toledo, J.B. Impact of dementia on hospitalization. Neuroepidemiology 2010, 35, 101–108. [Google Scholar] [CrossRef] [PubMed]
- Lu, P.; Cao, Z.; Gu, H.; Li, Z.; Wang, Y.; Cui, L.; Wang, Y.; Zhao, X. Association of sex and age with in-hospital mortality and complications of patients with intracerebral hemorrhage: A study from the Chinese Stroke Center Alliance. Brain Behav. 2023, 13, e2846. [Google Scholar] [CrossRef] [PubMed]
- Kaczynski, A.; Michalowsky, B.; Eichler, T.; Thyrian, J.R.; Wucherer, D.; Zwingmann, I.; Hoffmann, W. Comorbidity in Dementia Diseases and Associated Health Care Resources Utilization and Cost. J. Alzheimers Dis. 2019, 68, 635–646. [Google Scholar] [CrossRef] [PubMed]
- Taudorf, L.; Norgaard, A.; Brodaty, H.; Laursen, T.M.; Waldemar, G. Dementia increases mortality beyond effects of comorbid conditions: A national registry-based cohort study. Eur. J. Neurol. 2021, 28, 2174–2184. [Google Scholar] [CrossRef] [PubMed]
- Cereda, E.; Klersy, C.; Hiesmayr, M.; Schindler, K.; Singer, P.; Laviano, A.; Caccialanza, R.; NutritionDay Survey Collaborators. Body mass index, age and in-hospital mortality: The NutritionDay multinational survey. Clin. Nutr. 2017, 36, 839–847. [Google Scholar] [CrossRef]
- Walicka, M.; Puzianowska-Kuznicka, M.; Chlebus, M.; Sliwczynski, A.; Brzozowska, M.; Rutkowski, D.; Kania, L.; Czech, M.; Jacyna, A.; Franek, E. Relationship between age and in-hospital mortality during 15,345,025 non-surgical hospitalizations. Arch. Med. Sci. 2021, 17, 40–46. [Google Scholar] [CrossRef]
- Toubol, A.; Moestrup, L.; Ryg, J.; Thomsen, K.; Nielsen, D.S. Stakeholder perspectives of the dementia-friendly hospital: A qualitative descriptive focus group study. Dementia 2021, 20, 1501–1517. [Google Scholar] [CrossRef]
- Hobday, J.V.; Gaugler, J.E.; Mittelman, M.S. Feasibility and Utility of Online Dementia Care Training for Hospital Staff: The CARES® Dementia-Friendly Hospital™ Program. Res. Gerontol. Nurs. 2017, 10, 58–65. [Google Scholar] [CrossRef]
- Buter, K.; Motzek, T.; Dietz, B.; Hofrichter, L.; Junge, M.; Kopf, D.; von Lutzau-Hohlbein, H.; Traxler, S.; Zieschang, T.; Marquardt, G. Dementia-friendly hospital wards: Expert recommendations for planning and design. Z. Gerontol. Geriatr. 2017, 50, 67–72. [Google Scholar] [CrossRef]
Patients with Dementia (n = 15,956) | Patients without Dementia (n = 15,956) | p-Value | |
---|---|---|---|
Mean age | |||
Mean age (SD) | 83.9 (6.5) | 83.9 (6.5) | 1.000 |
60–70 years, n (%) | 531 (3.3) | 531 (3.3) | |
71–80 years, n (%) | 3732 (23.4) | 3732 (23.4) | |
81–75 years, n (%) | 5010 (31.4) | 5010 (31.4) | 1.000 |
86–90 years, n (%) | 4297 (26.9) | 4297 (26.9) | |
>90 years, n (%) | 2386 (15.0) | 2386 (15.0) | |
Gender, n (%) | |||
Female | 9691 (60.7) | 9691 (60.7) | |
Male | 6265 (39.3) | 6265 (39.3) | 1.000 |
Hospital department, n (%) | |||
Internal medicine | 4258 (27.0) | 4258 (27.0) | |
Surgery | 2991 (19.0) | 2991 (19.0) | |
Geriatrics | 2368 (15.0) | 2368 (15.0) | 1.000 |
Cardiology | 1398 (8.9) | 1398 (8.9) | |
Gastroenterology | 1370 (8.7) | 1370 (8.7) | |
Other departments | 3571 (22.4) | 3571 (22.4) | |
Length of hospital stay | |||
Mean length of stay (SD) | 10.1 (9.4) | 9.9 (9.6) | 0.002 |
Main diagnosis, n (%) | |||
Injuries and fractures | 3487 (21.9) | 3487 (21.9) | 1.000 |
Cardiovascular and cerebrovascular disorders | 2810 (17.6) | 2810 (17.6) | |
Pneumonia | 1818 (11.4) | 1818 (11.4) | |
Digestive system disorders | 1409 (8.8) | 1409 (8.8) | |
Endocrine, nutritional, and metabolic diseases | 1280 (8.0) | 1280 (8.0) | |
Infectious and parasitic diseases | 858 (5.4) | 858 (5.4) | |
Urinary tract infections | 767 (4.8) | 767 (4.8) | |
Cancer | 446 (2.8) | 446 (2.8) | |
Neurological diseases | 321 (2.0) | 321 (2.0) | |
Musculoskeletal system disorders | 260 (1.6) | 260 (1.6) | |
Renal failure | 280 (1.8) | 280 (1.8) | |
COPD | 177 (1.1) | 177 (1.1) | |
Other disorders | 2034 (12.8) | 2034 (12.8) |
Main Diagnosis | In-Hospital Mortality among Patients with Dementia (%) | In-Hospital Mortality among Patients without Dementia (%) | OR (95% CI) | p Value |
---|---|---|---|---|
Total | 14.0 | 11.7 | 1.24 (1.16–1.32) | <0.001 |
Injuries and fractures | 6.5 | 7.2 | 0.89 (0.74–1.08) | 0.236 |
Cardiovascular and cerebrovascular disorders | 17.4 | 12.2 | 1.51 (1.30–1.75) | <0.001 |
Pneumonia | 35.0 | 31.0 | 1.20 (1.04–1.37) | 0.011 |
Digestive system disorders | 12.0 | 8.5 | 1.58 (1.15–1.89) | 0.002 |
Endocrine, nutritional, and metabolic diseases | 9.1 | 6.6 | 1.42 (1.06–1.90) | 0.019 |
Infectious and parasitic diseases | 21.1 | 18.4 | 1.18 (0.93–1.50) | 0.163 |
Urinary tract infections | 8.3 | 6.3 | 1.36 (0.93–2.01) | 0.118 |
Cancer | 17.5 | 13.5 | 1.36 (0.95–1.97) | 0.096 |
Neurological diseases | 7.8 | 7.8 | 1.00 (0.56–1.78) | 1.000 |
Musculoskeletal system disorders | 3.9 | 2.3 | 1.69 (0.61–4.73) | 0.315 |
Renal failure | 28.2 | 24.6 | 1.20 (0.83–1.75) | 0.338 |
COPD | 21.5 | 14.7 | 1.59 (0.92–2.75) | 0.099 |
Other disorders | 6.1 | 5.1 | 1.19 (0.91–1.56) | 0.197 |
Main Diagnosis | In-Hospital Mortality among Patients with Dementia (%) | In-Hospital Mortality among Patients without Dementia (%) | OR (95% CI) | p Value |
---|---|---|---|---|
Internal medicine | 19.4 | 15.5 | 1.31 (1.17–1.47) | <0.001 |
Surgery | 9.7 | 8.2 | 1.20 (1.00–1.43) | 0.046 |
Geriatrics | 5.6 | 6.1 | 0.92 (0.72–1.17) | 0.456 |
Cardiology | 17.5 | 14.1 | 1.30 (1.06–1.59) | 0.013 |
Gastroenterology | 15.4 | 11.6 | 1.39 (1.11–1.73) | 0.004 |
Other departments | 14.9 | 12.8 | 1.20 (1.05–1.37) | 0.009 |
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content. |
© 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Kostev, K.; Michalowsky, B.; Bohlken, J. In-Hospital Mortality in Patients with and without Dementia across Age Groups, Clinical Departments, and Primary Admission Diagnoses. Brain Sci. 2024, 14, 455. https://doi.org/10.3390/brainsci14050455
Kostev K, Michalowsky B, Bohlken J. In-Hospital Mortality in Patients with and without Dementia across Age Groups, Clinical Departments, and Primary Admission Diagnoses. Brain Sciences. 2024; 14(5):455. https://doi.org/10.3390/brainsci14050455
Chicago/Turabian StyleKostev, Karel, Bernhard Michalowsky, and Jens Bohlken. 2024. "In-Hospital Mortality in Patients with and without Dementia across Age Groups, Clinical Departments, and Primary Admission Diagnoses" Brain Sciences 14, no. 5: 455. https://doi.org/10.3390/brainsci14050455
APA StyleKostev, K., Michalowsky, B., & Bohlken, J. (2024). In-Hospital Mortality in Patients with and without Dementia across Age Groups, Clinical Departments, and Primary Admission Diagnoses. Brain Sciences, 14(5), 455. https://doi.org/10.3390/brainsci14050455