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Six-month outcomes following an emergency hospital admission for older adults with co-morbid mental health problems indicate complexity of care needs
Background: two-thirds of older patients admitted as an emergency to a general hospital have co-existing mental health problems including delirium, dementia and depression. This study describes the outcomes of older adults with co-morbid mental health problems after an acute hospital admission. Meth...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2013
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3745087/ https://www.ncbi.nlm.nih.gov/pubmed/23800454 http://dx.doi.org/10.1093/ageing/aft074 |
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author | Bradshaw, Lucy E. Goldberg, Sarah E. Lewis, Sarah A. Whittamore, Kathy Gladman, John R. F. Jones, Rob G. Harwood, Rowan H. |
author_facet | Bradshaw, Lucy E. Goldberg, Sarah E. Lewis, Sarah A. Whittamore, Kathy Gladman, John R. F. Jones, Rob G. Harwood, Rowan H. |
author_sort | Bradshaw, Lucy E. |
collection | PubMed |
description | Background: two-thirds of older patients admitted as an emergency to a general hospital have co-existing mental health problems including delirium, dementia and depression. This study describes the outcomes of older adults with co-morbid mental health problems after an acute hospital admission. Methods: a follow-up study of 250 patients aged over 70 admitted to 1 of 12 wards (geriatric, medical or orthopaedic) of an English acute general hospital with a co-morbid mental health problem and followed up at 180 days. Results: twenty-seven per cent did not return to their original place of residence after the hospital admission. After 180 days 31% had died, 42% had been readmitted and 24% of community residents had moved to a care home. Only 31% survived without being readmitted or moving to a care home. However, 16% spent >170 of the 180 days at home. Significant predictors for poor outcomes were co-morbidity, nutrition, cognitive function, reduction in activities of daily living ability prior to admission, behavioural and psychiatric problems and depression. Only 42% of survivors recovered to their pre-acute illness level of function. Clinically significant behavioural and psychiatric symptoms were present at follow-up in 71% of survivors with baseline cognitive impairment, and new symptoms developed frequently in this group. Conclusions: the variable, but often adverse, outcomes in this group implies a wide range of health and social care needs. Community and acute services to meet these needs should be anticipated and provided for. |
format | Online Article Text |
id | pubmed-3745087 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2013 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-37450872013-08-19 Six-month outcomes following an emergency hospital admission for older adults with co-morbid mental health problems indicate complexity of care needs Bradshaw, Lucy E. Goldberg, Sarah E. Lewis, Sarah A. Whittamore, Kathy Gladman, John R. F. Jones, Rob G. Harwood, Rowan H. Age Ageing Research Papers Background: two-thirds of older patients admitted as an emergency to a general hospital have co-existing mental health problems including delirium, dementia and depression. This study describes the outcomes of older adults with co-morbid mental health problems after an acute hospital admission. Methods: a follow-up study of 250 patients aged over 70 admitted to 1 of 12 wards (geriatric, medical or orthopaedic) of an English acute general hospital with a co-morbid mental health problem and followed up at 180 days. Results: twenty-seven per cent did not return to their original place of residence after the hospital admission. After 180 days 31% had died, 42% had been readmitted and 24% of community residents had moved to a care home. Only 31% survived without being readmitted or moving to a care home. However, 16% spent >170 of the 180 days at home. Significant predictors for poor outcomes were co-morbidity, nutrition, cognitive function, reduction in activities of daily living ability prior to admission, behavioural and psychiatric problems and depression. Only 42% of survivors recovered to their pre-acute illness level of function. Clinically significant behavioural and psychiatric symptoms were present at follow-up in 71% of survivors with baseline cognitive impairment, and new symptoms developed frequently in this group. Conclusions: the variable, but often adverse, outcomes in this group implies a wide range of health and social care needs. Community and acute services to meet these needs should be anticipated and provided for. Oxford University Press 2013-09 2013-06-25 /pmc/articles/PMC3745087/ /pubmed/23800454 http://dx.doi.org/10.1093/ageing/aft074 Text en © The Author 2013. Published by Oxford University Press on behalf of the British Geriatrics Society. http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Research Papers Bradshaw, Lucy E. Goldberg, Sarah E. Lewis, Sarah A. Whittamore, Kathy Gladman, John R. F. Jones, Rob G. Harwood, Rowan H. Six-month outcomes following an emergency hospital admission for older adults with co-morbid mental health problems indicate complexity of care needs |
title | Six-month outcomes following an emergency hospital admission for older adults with co-morbid mental health problems indicate complexity of care needs |
title_full | Six-month outcomes following an emergency hospital admission for older adults with co-morbid mental health problems indicate complexity of care needs |
title_fullStr | Six-month outcomes following an emergency hospital admission for older adults with co-morbid mental health problems indicate complexity of care needs |
title_full_unstemmed | Six-month outcomes following an emergency hospital admission for older adults with co-morbid mental health problems indicate complexity of care needs |
title_short | Six-month outcomes following an emergency hospital admission for older adults with co-morbid mental health problems indicate complexity of care needs |
title_sort | six-month outcomes following an emergency hospital admission for older adults with co-morbid mental health problems indicate complexity of care needs |
topic | Research Papers |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3745087/ https://www.ncbi.nlm.nih.gov/pubmed/23800454 http://dx.doi.org/10.1093/ageing/aft074 |
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