The association between dementia severity and hospitalisation profile in a newly assessed clinical cohort: the South London and Maudsley case register
Objectives To evaluate the risk and common causes of hospitalisation in patients with newly diagnosed dementia and variation by severity of cognitive impairment.Setting We used data from a large London mental healthcare case register linked to a national hospitalisation database.Participants Individ...
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BMJ Publishing Group
2020-04-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/10/4/e035779.full |
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| author | Robert Stewart Gayan Perera Usha Gungabissoon Nicholas W Galwey |
| author_facet | Robert Stewart Gayan Perera Usha Gungabissoon Nicholas W Galwey |
| author_sort | Robert Stewart |
| collection | DOAJ |
| description | Objectives To evaluate the risk and common causes of hospitalisation in patients with newly diagnosed dementia and variation by severity of cognitive impairment.Setting We used data from a large London mental healthcare case register linked to a national hospitalisation database.Participants Individuals aged ≥65 years with newly diagnosed dementia with recorded cognitive function and the catchment population within the same geography.Outcome measures We evaluated the risk and duration of hospitalisation in the year following a dementia diagnosis. In addition we identified the most common causes of hospitalisation and calculated age-standardised and gender-standardised admission ratios by dementia severity (mild/moderate/severe) relative to the catchment population.Results Of the 5218 patients with dementia, 2596 (49.8%) were hospitalised in the year following diagnosis. The proportion of individuals with mild, moderate and severe dementia who had a hospital admission was 47.9%, 50.8% and 51.7%, respectively (p= 0.097). Duration of hospital stay increased with dementia severity (median 2 days in mild to 4 days in severe dementia, p 0.0001). After excluding readmissions for the same cause, the most common primary hospitalisation discharge diagnoses among patients with dementia were urinary system disorders, pneumonia and fracture of femur, accounting for 15%, 10% and 6% of admissions, respectively. Overall, patients with dementia were hospitalised 30% more than the catchment population, and this trend was observed for most of the discharge diagnoses evaluated. Standardised admission ratios for urinary and respiratory disorders were higher in those with more severe dementia at diagnosis.Conclusions Individuals with a dementia diagnosis were more likely to be hospitalised than individuals in the catchment population. The length of hospital stay increased with dementia severity. Most of the common causes of hospitalisation were more common than expected relative to the catchment population, but standardised admission ratios only varied by dementia stage for certain groups of conditions. |
| format | Article |
| id | doaj-art-db457fcc45f744569fb579871249b4e6 |
| institution | OA Journals |
| issn | 2044-6055 |
| language | English |
| publishDate | 2020-04-01 |
| publisher | BMJ Publishing Group |
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| series | BMJ Open |
| spelling | doaj-art-db457fcc45f744569fb579871249b4e62025-08-20T02:30:30ZengBMJ Publishing GroupBMJ Open2044-60552020-04-0110410.1136/bmjopen-2019-035779The association between dementia severity and hospitalisation profile in a newly assessed clinical cohort: the South London and Maudsley case registerRobert Stewart0Gayan Perera1Usha Gungabissoon2Nicholas W Galwey3Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UKPsychological Medicine, King`s College London (Institute of Psychiatry, Psychology and Neuroscience), London, UKPsychological Medicine, King`s College London, Institute of Psychiatry Psychology and Neuroscience, London, UKstatistics leaderObjectives To evaluate the risk and common causes of hospitalisation in patients with newly diagnosed dementia and variation by severity of cognitive impairment.Setting We used data from a large London mental healthcare case register linked to a national hospitalisation database.Participants Individuals aged ≥65 years with newly diagnosed dementia with recorded cognitive function and the catchment population within the same geography.Outcome measures We evaluated the risk and duration of hospitalisation in the year following a dementia diagnosis. In addition we identified the most common causes of hospitalisation and calculated age-standardised and gender-standardised admission ratios by dementia severity (mild/moderate/severe) relative to the catchment population.Results Of the 5218 patients with dementia, 2596 (49.8%) were hospitalised in the year following diagnosis. The proportion of individuals with mild, moderate and severe dementia who had a hospital admission was 47.9%, 50.8% and 51.7%, respectively (p= 0.097). Duration of hospital stay increased with dementia severity (median 2 days in mild to 4 days in severe dementia, p 0.0001). After excluding readmissions for the same cause, the most common primary hospitalisation discharge diagnoses among patients with dementia were urinary system disorders, pneumonia and fracture of femur, accounting for 15%, 10% and 6% of admissions, respectively. Overall, patients with dementia were hospitalised 30% more than the catchment population, and this trend was observed for most of the discharge diagnoses evaluated. Standardised admission ratios for urinary and respiratory disorders were higher in those with more severe dementia at diagnosis.Conclusions Individuals with a dementia diagnosis were more likely to be hospitalised than individuals in the catchment population. The length of hospital stay increased with dementia severity. Most of the common causes of hospitalisation were more common than expected relative to the catchment population, but standardised admission ratios only varied by dementia stage for certain groups of conditions.https://bmjopen.bmj.com/content/10/4/e035779.full |
| spellingShingle | Robert Stewart Gayan Perera Usha Gungabissoon Nicholas W Galwey The association between dementia severity and hospitalisation profile in a newly assessed clinical cohort: the South London and Maudsley case register BMJ Open |
| title | The association between dementia severity and hospitalisation profile in a newly assessed clinical cohort: the South London and Maudsley case register |
| title_full | The association between dementia severity and hospitalisation profile in a newly assessed clinical cohort: the South London and Maudsley case register |
| title_fullStr | The association between dementia severity and hospitalisation profile in a newly assessed clinical cohort: the South London and Maudsley case register |
| title_full_unstemmed | The association between dementia severity and hospitalisation profile in a newly assessed clinical cohort: the South London and Maudsley case register |
| title_short | The association between dementia severity and hospitalisation profile in a newly assessed clinical cohort: the South London and Maudsley case register |
| title_sort | association between dementia severity and hospitalisation profile in a newly assessed clinical cohort the south london and maudsley case register |
| url | https://bmjopen.bmj.com/content/10/4/e035779.full |
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