TY - JOUR
T1 - Health-related quality of life at hospital discharge as a predictor for 6-month unplanned readmission and all-cause mortality of acutely admitted older medical patients
AU - Andreasen, Jane
AU - Gobbens, Robbert J J
AU - Eriksen, Helle Højmark
AU - Overvad, Kim
PY - 2019/11/1
Y1 - 2019/11/1
N2 - Purpose: To assess whether health-related quality of life (HRQOL) status, using the European Quality of life-5 dimensions (EQ5D), in acutely admitted older medical patients was associated with a combined end-point including first unplanned readmission or death without prior readmission within 6 months. Secondly, to assess if HRQOL was associated with death regardless of previous readmissions. Methods: Patients from seven medical and two acute medical units were included and the EQ5D was obtained at discharge. Associations were assessed using Cox regression. Harrell’s C-statistics indicated the predictive performance. Results: 1328 patients were included, 50% (n = 664) were readmitted (n = 635) or had died without prior readmission (n = 29) within 6 months. In total, 15.2% (n = 202) died within 6 months. In the gender- and age-adjusted analysis, a lower EQ5D index score was associated with a higher hazard ratio (HR) of unplanned readmission or death without prior readmission for all categories of scores below 1 (< 1 to 0.741, < 0.741 to 0.438 and < 0.438 to − 0.40), HR 1.60, 1.93 and 2.02. Likewise, a lower EQ5D score was associated with a higher HR of death, HR 1.72, 2.54 and 3.79. Harrell’s C values were 0.56 and 0.63. Conclusion: HRQOL measured at discharge may identify acutely admitted older medical patients at especially high risk of readmission or death up to 6 months after discharge. Incorporating assessment of HRQOL should be considered when risk stratifying a heterogeneous population of acutely admitted older medical patients.
AB - Purpose: To assess whether health-related quality of life (HRQOL) status, using the European Quality of life-5 dimensions (EQ5D), in acutely admitted older medical patients was associated with a combined end-point including first unplanned readmission or death without prior readmission within 6 months. Secondly, to assess if HRQOL was associated with death regardless of previous readmissions. Methods: Patients from seven medical and two acute medical units were included and the EQ5D was obtained at discharge. Associations were assessed using Cox regression. Harrell’s C-statistics indicated the predictive performance. Results: 1328 patients were included, 50% (n = 664) were readmitted (n = 635) or had died without prior readmission (n = 29) within 6 months. In total, 15.2% (n = 202) died within 6 months. In the gender- and age-adjusted analysis, a lower EQ5D index score was associated with a higher hazard ratio (HR) of unplanned readmission or death without prior readmission for all categories of scores below 1 (< 1 to 0.741, < 0.741 to 0.438 and < 0.438 to − 0.40), HR 1.60, 1.93 and 2.02. Likewise, a lower EQ5D score was associated with a higher HR of death, HR 1.72, 2.54 and 3.79. Harrell’s C values were 0.56 and 0.63. Conclusion: HRQOL measured at discharge may identify acutely admitted older medical patients at especially high risk of readmission or death up to 6 months after discharge. Incorporating assessment of HRQOL should be considered when risk stratifying a heterogeneous population of acutely admitted older medical patients.
KW - Cohort study
KW - Denmark
KW - EQ5D
KW - Health-related quality of life
KW - Older medical in-patients
KW - Readmission or mortality
UR - http://www.scopus.com/inward/record.url?scp=85073668861&partnerID=8YFLogxK
U2 - 10.1007/s11136-019-02259-w
DO - 10.1007/s11136-019-02259-w
M3 - Journal article
C2 - 31377940
SN - 0962-9343
VL - 28
SP - 3015
EP - 3024
JO - Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation
JF - Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation
IS - 11
ER -