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

Guillaume Deschasse,1,2 Elodie Drumez,2,3 Fabien Visade,2,4 Anne Charpentier,5 Céline Delecluse,4 Gilles Loggia,6,7 Pascale Lescure,7 Jadwiga Attier-Żmudka,8,9 Jennifer Bloch,5 Cédric Gaxatte,5 Frédéric Bloch,1 François Puisieux,5 Jean-Baptiste Beuscart2,5 1Department of Geriatrics, CHU Ami...
Ausführliche Beschreibung

Guillaume Deschasse,1,2 Elodie Drumez,2,3 Fabien Visade,2,4 Anne Charpentier,5 Céline Delecluse,4 Gilles Loggia,6,7 Pascale Lescure,7 Jadwiga Attier-Żmudka,8,9 Jennifer Bloch,5 Cédric Gaxatte,5 Frédéric Bloch,1 François Puisieux,5 Jean-Baptiste Beuscart2,5 1Department of Geriatrics, CHU Amiens-Picardie, Amiens, France; 2ULR 2694 - METRICS: Évaluation des technologies de santé et des pratiques médicales, University Lille, CHU Lille, Lille, France; 3Department of Biostatistics, CHU Lille, Lille, France; 4Geriatrics Department, Lille Catholic Hospitals, Lille, France; 5Department of Geriatrics, CHU Lille, Lille, France; 6COMETE, INSERM, Normandie Univ, UNICAEN, Caen, France; 7Department of Geriatrics, Normandie Univ, UNICAEN, CHU de Caen Normandie, Caen, France; 8Geriatric Department, General Hospital of Saint-Quentin, Saint-Quentin, France; 9CHIMERE EA 7516 Team Research, Jules Verne University, Amiens, FranceCorrespondence: Guillaume Deschasse, Department of Geriatrics, CHU Amiens-Picardie, Amiens, France, Tel +33-322-088-000, Fax + 33-322-455-748, Email deschasse.guillaumechu-amiens.frBackground: 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.Keywords: care transitions, health services, rehabilitation, risk factors, acute geriatric unit Ausführliche Beschreibung