The Combined Effect of Delirium and Falls on Length of Stay and Discharge.

IF 0.9 4区医学 Q4 HEALTH CARE SCIENCES & SERVICES

Journal for Healthcare Quality Pub Date : 2023-05-01 DOI:10.1097/JHQ.0000000000000377

Benjamin Kalivas, Jingwen Zhang, Kristine Harper, Jennifer Dulin, Marc Heincelman, Justin Marsden, Kelly J Hunt, Patrick D Mauldin, William P Moran, Meghan K Thomas

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引用次数: 0

Abstract

Introduction: Delirium or a fall are associated with many negative outcomes including increased length of stay (LOS) and discharge to a facility; however, this relationship is incompletely understood.

Methods: A cross-sectional study of all hospitalizations in a large, tertiary care hospital evaluated the effect of delirium and a fall on the outcomes of LOS and risk of being discharged to a facility.

Results: The study included 29,655 hospital admissions. A total of 3,707 (12.5%) patients screened positive for delirium and 286 (0.96%) had a reported fall. After adjustment for covariates, relative to patients without delirium or a fall, patients with delirium only had a 1.64-fold longer LOS; patients with fall only had a 1.96-fold longer LOS; and patients who had delirium and fall had a 2.84-fold longer LOS. The adjusted odds of discharge to a facility, relative to those without delirium or a fall, was 8.98 times higher in those with delirium and a fall.

Conclusions: Delirium and falls influence LOS and likelihood of being discharged to a facility. The joint impact of falls and delirium on LOS and facility discharge was more than additive. Hospitals should consider the integrated management of delirium and falls.

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谵妄和跌倒对住院时间和出院时间的综合影响。

前言:谵妄或跌倒与许多负面结果相关，包括住院时间延长(LOS)和出院;然而，这种关系并没有被完全理解。方法:对一家大型三级医院的所有住院患者进行横断面研究，评估谵妄和跌倒对LOS结果和出院风险的影响。结果:该研究包括29,655名住院患者。共有3707例(12.5%)患者筛查为谵妄阳性，286例(0.96%)患者报告跌倒。调整协变量后，相对于没有谵妄或跌倒的患者，谵妄患者的LOS仅长1.64倍;跌倒患者的LOS仅延长1.96倍;而谵妄和跌倒的患者的LOS长2.84倍。与没有精神错乱或跌倒的人相比，精神错乱和跌倒的人调整后出院的几率高出8.98倍。结论:谵妄和跌倒影响LOS和出院的可能性。跌倒和谵妄对LOS和设施排放的共同影响大于相加。医院应考虑谵妄和跌倒的综合管理。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal for Healthcare Quality HEALTH CARE SCIENCES & SERVICES-

CiteScore

2.10

自引率

0.00%

发文量

期刊介绍： The Journal for Healthcare Quality (JHQ), a peer-reviewed journal, is an official publication of the National Association for Healthcare Quality. JHQ is a professional forum that continuously advances healthcare quality practice in diverse and changing environments, and is the first choice for creative and scientific solutions in the pursuit of healthcare quality. It has been selected for coverage in Thomson Reuter’s Science Citation Index Expanded, Social Sciences Citation Index®, and Current Contents®. The Journal publishes scholarly articles that are targeted to leaders of all healthcare settings, leveraging applied research and producing practical, timely and impactful evidence in healthcare system transformation. The journal covers topics such as: Quality Improvement • Patient Safety • Performance Measurement • Best Practices in Clinical and Operational Processes • Innovation • Leadership • Information Technology • Spreading Improvement • Sustaining Improvement • Cost Reduction • Payment Reform