Highlights
- •The in-hospital mortality rate in our study was 11.1%.
- •Factors that increased the in-hospital mortality rate were: male sex, higher age, living with a partner, acute admission and Alzheimer’s disease.
- •Cardiovascular disease was the most common cause of death in our cohort.
- •Male sex, higher age, living with a partner, acute admission and Alzheimer’s disease increase in-hospital mortality.
Abstract
Objective
To examine the in-hospital mortality rate, and its risk factors, for patients with
dementia admitted to hospital.
Study design
We constructed an observational cohort study through data linkage of three Dutch national
registers: the hospital discharge register (HDR), the population register (PR) and
the national cause of death register. Patients with dementia in the HDR aged between
60 and 100 years registered between 1 January 2000 and 31 December 2010 were included.
Main outcome measures
Risk factors for in-hospital mortality were investigated using multivariable Cox proportional
hazard regression models that included sex, age, marital status, ethnicity, somatic
comorbidity, type of dementia and urgency of admission.
Results
40,500 patients were included in the cohort. The overall in-hospital mortality rate
was 11.1%. Factors that significantly increased the mortality risk were: male sex
(adjusted hazard ratio (HR) 1.52, 95%-confidence interval (95%-CI) 1.43–1.63), higher
age (adjusted HR 1.03, 95%-CI 1.03–1.04), living with a partner (adjusted HR 1.39,
95%-CI 1.30–1.49), acute admission (adjusted HR 2.16, 95%-CI 1.97–2.36) and Alzheimer’s
disease (adjusted HR 1.21, 95%-CI 1.13–1.29). Cardiovascular disease was the most
common cause of in-hospital mortality.
Conclusions
This nationwide study found several independent risk factors for the in-hospital mortality
of patients with dementia, including male sex, higher age, living with a partner,
acute admission, and Alzheimer’s disease. These risk factors should be taken into
account by clinicians and caregivers as they will indicate whether patients are at
risk of a more unfavourable outcome during hospital admission.
Keywords
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Article info
Publication history
Published online: August 20, 2019
Accepted:
August 14,
2019
Received in revised form:
June 11,
2019
Received:
March 25,
2019
Identification
Copyright
© 2019 Elsevier B.V. All rights reserved.
