Characteristics and Psychosocial Predictors of Psychiatric Emergency Center Transport and Length of Stay in Patients with Dementia and Alzheimer's Disease

Nejtek, Vicki A.; Hardy, Sarah; Hall, James; Winter, A. Scott

doi:10.1097/01.pra.0000400262.45290.66

Cited by 9 publications

(7 citation statements)

References 12 publications

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“…Attempts were made to comprehensively investigate patient background factors, but eight of these were BPSD. Several studies have indicated that agitation and aggression are risk factors for hospital admission . Patients with dementia can become aggressive, and dementia is associated with significantly increased use of psychotropic medication and injuries .…”

Section: Discussionmentioning

confidence: 99%

“…Several studies have indicated that agitation and aggression are risk factors for hospital admission. 27,28 Patients with dementia can become aggressive, and dementia is associated with significantly increased use of psychotropic medication and injuries. 29 These behavioural and psychological symptoms increase the burden placed on caregivers, which can lead to hospital admission.…”

Section: Discussionmentioning

confidence: 99%

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Factors influencing hospital admission among patients with autopsy‐confirmed dementia

et al. 2019

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Background The symptoms of geriatric syndromes and the behavioural and psychological symptoms of dementia (BPSD), in addition to clinical conditions, are associated with hospital admission among dementia patients. However, the principal factors that necessitate hospital admission among dementia patients have not been fully elucidated. Methods We retrospectively reviewed the data in the medical and autopsy reports of patients who had been treated at a hospital in Toyohashi, Japan. Each patient had been hospitalized sometime between 2012 and 2016 and underwent a brain autopsy. Dementia and the subtypes of dementia were diagnosed neuropathologically. Information about patients’ general backgrounds, clinical conditions at the time of admission, and the geriatric syndrome symptoms and BPSD before admission was collected; comparisons were then made between patients with and without dementia and among those with the different major subtypes of dementia. Then, the factors relating to hospital admission of dementia patients were comprehensively evaluated by using principle component analysis. Results Of the 128 eligible patients, 100 (78.1%) had dementia. In the comparison of patients with and without dementia, patients without dementia were younger at both admission (P = 0.034) and death (P = 0.003). Among the patients with dementia with Lewy bodies, delusions had a significantly high prevalence (P = 0.014). Principal component analysis identified nine components (disinhibition, irritability/lability, agitation/aggression, anxiety, delusions, sleep/night‐time behaviour disorders, hallucinations, aberrant motor behaviour, and speech impairment) as the principal factors related to hospital admission among dementia patients. Thus, BPSD were identified as principal factors. Conclusions Compared to other factors, BPSD are more likely to cause dementia patients to be admitted to hospital. The present results indicate that measures should be taken to ameliorate the difficulties associated with caring for patients with BPSD at home.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Factors influencing hospital admission among patients with autopsy‐confirmed dementia

et al. 2019

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“…Evidence of risk factors of ER use among residents in LTCFs is relatively sparse (Tang et al, 2010). Several studies reported on the relationship between ER use and prescribed medications (Tang et al, 2010), use of psychotropic drugs (Centers for Disease Control and Prevention, 2010;Nejtek, Hardy, Hall, & Winter, 2011), and cognition (Nejtek et al, 2011). Previous studies also found that polypharmacy and declines in cognitive functioning and ADL (e.g., O'Malley, Caudry, & Grabowski, 2011;Tang et al, 2010) were positively associated with hospitalization among residents in LTCFs.…”

Section: Patterns Of Hospitalization and Emergency Room Usementioning

confidence: 99%

Residents with Alzheimer's disease in long-term care facilities in Hong Kong: patterns of hospitalization and emergency room use

Leung

Kwan

Chi

2013

Aging & Mental Health

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“…To our knowledge, our study is the second article that examines predictors of hospitalization outcomes in dementia patients with agitation. ( 7 ) The study by Nejtek et al . examined psychosocial factors, number of visits to the emergency room, and length of stay in hospital as the main outcome measures.…”

Section: Discussionmentioning

confidence: 99%

“…However, there is only one previous study that examined predictors of hospitalization outcomes in dementia patients with agitation, focusing on psychosocial factors predicting number of visits to the emergency room and length of stay in hospital. ( 7 ) There are a number of unanswered questions in this field, such as whether certain pharmacotherapies or other clinical/demographic variables can predict length of stay. Based on previous clinical trials using symptom rating scales, risperidone is expected to be more efficacious than other pharmacological treatments.…”

Section: Introductionmentioning

confidence: 99%

Management of Agitation in Dementia and Effects on Inpatient Length of Stay

Silverstone-Simard

Nassim

et al. 2021

Can Geri J

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Background Agitation associated with dementia impacts delivery of medical care and is a major reason for institutionalization in dementia patients. This study examines the association of medication use and other clinical factors with patients’ ‘dischargeability’ (i.e., amount of time until a patient is considered dischargeable from an inpatient unit). Methods This study was a retrospective chart review examining 200 patients with dementia and agitation, hospitalized at a Canadian acute care geriatric ward between November 2007 and November 2018. The main outcome measure was time until a patient was deemed dischargeable. Univariate linear regression analyses, followed by multiple linear regression analyses, were used. Results Risperidone and quetiapine were the most commonly prescribed medications, but were not associated with time until dischargeable. Olanzapine (40.9 vs. 16.2 days until dischargeable, β = 0.23, p = .001), regular benzodiazepine (32.7 vs. 16.5 days until dischargeable, β = 0.15, p = .027), and as-needed (‘PRN’) benzodiazepine use (31.7 vs. 15.9 days until dischargeable, β =0.19, p = .006) were independently associated with prolonging time until dischargeable. Conclusions Olanzapine, benzodiazepine, and PRN benzodiazepine use were associated with longer time until patients with dementia and agitation were considered ready for discharge. This raises the question as to whether the risks of these medications outweigh the benefits in a hospital setting.

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Characteristics and Psychosocial Predictors of Psychiatric Emergency Center Transport and Length of Stay in Patients with Dementia and Alzheimer's Disease

Cited by 9 publications

References 12 publications

Factors influencing hospital admission among patients with autopsy‐confirmed dementia

Factors influencing hospital admission among patients with autopsy‐confirmed dementia

Residents with Alzheimer's disease in long-term care facilities in Hong Kong: patterns of hospitalization and emergency room use

Management of Agitation in Dementia and Effects on Inpatient Length of Stay

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