Factors Associated with Transfer from an Acute Geriatric Unit to a Post-Acute Care Facility among Community-Dwelling Patients: Results from the DAMAGE Cohort

Abstract

Background Acute geriatric units (AGUs) require efficient discharge planning tools. Risk factors for discharge from an AGU to post-acute care (PAC) have not previously been investigated in detail. Methods The objective is to identify risk factors for PAC transfer. The DAMAGE (prospective multicenter cohort) consecutively included more than 3500 subjects aged 75 or older and admitted to an AGU. The patients underwent a comprehensive geriatric assessment (CGA) during their stay in the AGU. Only community-dwelling patients admitted to the AGU from the emergency department were included in the analysis. We recorded the characteristics of the care pathway and identified risk factors for discharge to home or to a PAC facility. Results 1928 patients were included. Loss of functional independence (a decrease in the Katz activities of daily living (ADL) score between 1 month prior to admission and AGU admission), living alone, social isolation, a high Katz ADL score at home, a low Katz ADL on admission, and delirium on admission were risk factors for transfer to PAC. Obesity, an elevated serum albumin level, and community-acquired infection were associated with discharge to home. Neither sex nor age was a risk factor for home discharge or transfer to PAC. Conclusion The present results might help clinicians and discharge planning teams to identify patients at risk of transfer to PAC more reliably and promptly in AGUs.