Multiple hospitalizations for dehydration, certain infections raise risk of death, study finds
Nursing home residents with advanced mental decline who undergo numerous hospitalizations for infections, dehydration or certain other health problems are at a higher risk of death, a new study finds. Researchers analyzed data from staff assessments of all nursing home residents in the United States between January 2000 and December 2008. Outcomes were then tracked for one year after the assessment. Among the 1.3 million residents who had moderate to very severe mental decline and survived for at least 30 days after assessment, the average overall length of survival after assessment was 476 days.
However, survival was much shorter for residents in this group who had two or more hospitalizations for the same type of the following problems: septicemia [blood infection], 89 days; pneumonia, 95 days; dehydration or malnutrition, 111 days; and urinary tract infection, 146 days.
Researchers led by Dr. Joan Teno of Brown University’s medical school said that more study is needed to discern whether repeat hospitalizations arise from financial pressures, “poor communication, or a lack of resources needed to diagnose and treat a [nursing home] resident.” They added that when a nursing home resident is hospitalized for the first time, this should be a red flag for a closer look at his or her case, with staff reassessing “the goals of care” and whether repeat hospitalizations are appropriate.
The findings appear in a research letter published July 16 in the Journal of the American Medical Association.