Home › Research › End-of-life care
Hospital transfers of nursing home residents with advanced dementia
Givens JL, Selby K, Goldfeld KS, Mitchell SL.. Journal of the American Geriatrics Society, 2012-03-16
Topic: Risk, prevention and care in population studies
Objectives To describe diagnoses and factors associated with hospital transfer in nursing home (NH) residents with advanced dementia. Design Prospective cohort study. Setting Twenty-two Boston, Massachusetts-area NHs. Participants Three hundred twenty-three NH residents with advanced dementia. Measurements Data were collected quarterly for up to 18 months. Data regarding transfers were collected with regard to hospitalization or emergency department (ED) visit, diagnosis, and duration of inpatient admission. Information on the occurrence of any acute medical event (pneumonia, febrile episode, or other acute illness) in the prior 90 days was obtained quarterly. Logistic regression conducted at the level of the acute medical event identified characteristics associated with hospital transfer. Results The entire cohort experienced 74 hospitalizations and 60 ED visits. Suspected infections were the most common reason for hospitalization (44, 59%), most frequently attributable to a respiratory source (30, 41%). Feeding tube-related complications accounted for 47% of ED visits. In adjusted analysis conducted on acute medical events, younger resident age, event type (pneumonia or other event vs febrile episode), chronic obstructive pulmonary disease, and the lack of a do-not-hospitalize (DNH) order (adjusted odds ratio = 5.22, 95% confidence interval = 2.31-11.79) were associated with hospital transfer. Conclusion The majority of hospitalizations of NH residents with advanced dementia were due to infections and thus were potentially avoidable, because infections are often treatable in the NH. Feeding tube-related complications accounted for almost half of all ED visits, representing a common but underrecognized burden of this intervention. Advance care planning in the form of a DNH order was the only identified modifiable factor associated with avoiding hospitalization.
Key findings
- Objectives To describe diagnoses and factors associated with hospital transfer in nursing home (NH) residents with advanced dementia.
- Logistic regression conducted at the level of the acute medical event identified characteristics associated with hospital transfer.
- Results The entire cohort experienced 74 hospitalizations and 60 ED visits.
- In adjusted analysis conducted on acute medical events, younger resident age, event type (pneumonia or other event vs febrile episode), chronic obstructive pulmonary disease, and the lack of a do-not-hospitalize (DNH) order (adjusted odds ratio = 5.22, 95% confidence interval = 2.31-11.79) were associated with hospital transfer.
- Advance care planning in the form of a DNH order was the only identified modifiable factor associated with avoiding hospitalization.
Study details
- Study designcohort study
- Evidence strengthModerate
How this study scored 52/100
Published in a peer-reviewed journal, and it is a cohort study following people over time. Scored zero for sample size, effect reported, studied in people and randomised / blinded because the record does not state it. We have no data on journal's citation record, times cited, citations per year, impact for its field and year, cited by studies here, still being cited, senior author's track record, institution's track record and multi-centre collaboration, so those were left out: it earned 30 of the 58 points we could judge it on, which is 52 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Journal of the American Geriatrics Society) |
| Journal's citation record | — / 4 | No journal record from OpenAlex — left out of this score |
| Study design | 7 / 12 | A cohort study following people over time |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2012 — within 20 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | — / 7 | No citation count (not found in OpenAlex) — left out of this score |
| Citations per year | — / 5 | No citation count or no year — left out of this score |
| Impact for its field and year | — / 6 | No field-weighted citation impact (OpenAlex has none yet) — left out of this score |
| Cited by studies here | — / 6 | Not yet checked against this library's citation graph — left out of this score |
| Still being cited | — / 4 | No yearly citation counts — left out of this score |
| Senior author's track record | — / 4 | Senior author's record not available — left out of this score |
| Institution's track record | — / 3 | No institution listed in OpenAlex — left out of this score |
| Multi-centre collaboration | — / 3 | Institutions not listed — left out of this score |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 22428661) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Points | 30 / 58 | Scored on 11 of 20 parts. We have no data for the rest, so they are left out: 30 of the 58 points we could judge it on is 52 out of 100. |
| Total | 52 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
Free copy unknown: no free-copy check has an answer for this record yet. That does not mean it is paywalled.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
APA 7th
Givens, J. L., Selby, K., Goldfeld, K. S., & Mitchell, S. L. (2012). Hospital transfers of nursing home residents with advanced dementia. Journal of the American Geriatrics Society. https://doi.org/10.1111/j.1532-5415.2012.03919.x
Vancouver
Givens JL, Selby K, Goldfeld KS, Mitchell SL. Hospital transfers of nursing home residents with advanced dementia. Journal of the American Geriatrics Society. 2012. doi:10.1111/j.1532-5415.2012.03919.x. PMID: 22428661.
BibTeX
@article{givens2012-22428661,
author = {Givens, J. L. and Selby, K. and Goldfeld, K. S. and Mitchell, S. L.},
title = {{Hospital transfers of nursing home residents with advanced dementia}},
journal = {Journal of the American Geriatrics Society},
year = {2012},
doi = {10.1111/j.1532-5415.2012.03919.x},
pmid = {22428661},
url = {https://doi.org/10.1111/j.1532-5415.2012.03919.x}
}
Related studies in End-of-life care
Also tagged “care”
996 studies in the library carry the topic tag “care”; these are this study's neighbours in a fixed, alphabetical-by-hash tour of them, not the closest in content. All 996 tagged studies.