Acute hospital care: how much activity is attributable to caring for patients with dementia?

Briggs, Robert; Coary, Roisin; Collins, Rónán; Coughlan, Tara; O’Neill, Desmond; Kennelly, Sean

doi:10.1093/qjmed/hcv085

Cited by 29 publications

(43 citation statements)

References 30 publications

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“…In most studies, CI or dementia increased length of hospital stay (LOS) . (Table ) Patients with DSD had longer mean LOS than those with dementia or delirium alone .…”

Section: Resultsmentioning

confidence: 62%

Hospital outcomes of older people with cognitive impairment: An integrative review

Fogg

Griffiths

Meredith

et al. 2018

Int J Geriat Psychiatry

159

137

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ObjectivesTo summarise existing knowledge of outcomes of older hospital patients with cognitive impairment, including the type and frequency of outcomes reported, and the additional risk experienced by this patient group.MethodsIntegrative literature review. Health care literature databases, reports, and policy documents on key websites were systematically searched. Papers describing the outcomes of older people with cognitive impairment during hospitalisation and at discharge were analysed and summarised using integrative methods.ResultsOne hundred four articles were included. A range of outcomes were identified, including those occurring during hospitalisation and at discharge. Older people with a dementia diagnosis were at higher risk from death in hospital, nursing home admission, long lengths of stay, as well as intermediate outcomes such as delirium, falls, dehydration, reduction in nutritional status, decline in physical and cognitive function, and new infections in hospital. Fewer studies examined the relationship of all‐cause cognitive impairment with outcomes. Patient and carer experiences of hospital admission were often poor. Few studies collected data relating to hospital environment, eg, ward type or staffing levels, and acuity of illness was rarely described.ConclusionsOlder people with cognitive impairment have a higher risk of a variety of negative outcomes in hospital. Prevalent intermediate outcomes suggest that changes in care processes are required to ensure maintenance of fundamental care provision and greater attention to patient safety in this vulnerable group. More research is required to understand the most appropriate ways of doing this and how changes in these care processes are best implemented to improve hospital outcomes.

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“…In most studies, CI or dementia increased length of hospital stay (LOS) . (Table ) Patients with DSD had longer mean LOS than those with dementia or delirium alone .…”

Section: Resultsmentioning

confidence: 62%

Hospital outcomes of older people with cognitive impairment: An integrative review

Fogg

Griffiths

Meredith

et al. 2018

Int J Geriat Psychiatry

159

137

View full text Add to dashboard Cite

show abstract

“…The sample size of the study populations varied between 42 and 10 669 449 . The study population of 13 studies consisted of admissions, discharges, or hospitalizations rather than individual participants . Mean or median age of patients among studies reporting such information ranged from 67 to 87.7 years, and minimum age ranged from 18 to 80 .…”

Section: Resultsmentioning

confidence: 99%

Length of hospital stay and dementia: A systematic review of observational studies

Möllers

Stocker

Wei

et al. 2018

Int J Geriat Psychiatry

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Objective Hospitalizations of people with dementia (PWD) are often accompanied by complications or functional loss and can lead to adverse outcomes. Unsystematic findings suggest an influence of comorbidities on the extent of differences in the length of hospital stay (LOS). This systematic review aimed to identify and evaluate all studies reporting LOS in PWD as compared to PwoD in general hospitals. Methods A systematic review of observational studies using PubMed and ISI Web of Knowledge. Inclusion criteria comprised original studies written in English or German, assessment of diagnosis of dementia, measurement of LOS, and comparison of people with and without dementia. Results Fifty‐two of 60 studies reported a longer hospitalization time for PWD compared to PwoD. The extent of the difference in LOS varied between and within countries as well as by type of primary morbidity (eg, injuries, cardiovascular diseases). The range of the LOS difference for studies without restriction to a primary morbidity was −2 to +22 days after matching or adjustment for a variable number and selection of potentially relevant covariates. For studies with injuries/fractures/medical procedures and infectious/vascular disease as the primary morbidity, the range was −2.9 to +12.4 and −11.2 to +21.8 days, respectively. Conclusions The majority of studies reported a longer hospitalization of PWD compared to PwoD. Length of hospital stay seems to be influenced by a variety of medical, social, organizational factors, including reasons for hospital admission, whose role should be explored in detail in further research.

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“…Dementia is very common in patients admitted to acute hospitals, affecting one in four patients, with 6% of people living with dementia being inpatients in acute hospitals at any given time [1,2]. Dementia is often unrecognised by doctors and other hospital staff and frequently complicated by delirium.…”

Section: What Is the Problem?mentioning

confidence: 99%

Challenges and opportunities in understanding dementia and delirium in the acute hospital

et al. 2017

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Acute hospital care: how much activity is attributable to caring for patients with dementia?

Cited by 29 publications

References 30 publications

Hospital outcomes of older people with cognitive impairment: An integrative review

Hospital outcomes of older people with cognitive impairment: An integrative review

Length of hospital stay and dementia: A systematic review of observational studies

Challenges and opportunities in understanding dementia and delirium in the acute hospital

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