Research Abstract: Free Paper - Poster Presentation Only Australian and New Zealand Society for Geriatric Medicine Annual Scientific Meeting 2023

Older adults admitted to hospital with a history of dementia are at increased risk of hospital acquired adverse events          (#129)

Danielle Ní Chróinín 1 2 , Vicki Deane 3 , Rinsy Pulikotil Zachariah 3 , Katrina Stott 4 , Bernadette Shepherd 5 , Margaret Perkins 5 , Leesa Giang 5 , Rozina Shekhar 6 , Vaulina Vueti 6 , Mandana Mayahi-Neysi 7 , Amy Montgomery 8 , Kaye Rolls 9 , Steve A. Frost 2 9 10 11
  1. Geriatric Medicine, Liverpool Hospital, Liverpool, NSW, Australia
  2. UNSW Sydney, South Western Sydney Clinical School, Liverpool, NSW, Australia
  3. Liverpool Hospital, Liverpool, NSW, Australia
  4. Bankstown-Lidcombe Hospital, Bankstown, NSW, Australia
  5. Campbelltown Hospital, Campbelltown, NSW, Australia
  6. Fairfield Hospital, Fairfield, NSW, Australia
  7. Bowral and District Hospital, Bowral, NSW, Australia
  8. School of Nursing, University of Wollongong, Wollongong, NSW, Australia
  9. South Western Sydney Nursing and Midwifery Research Alliance, University of Wollongong , Wollongong , NSW, Australia
  10. Liverpool Hospital / South Western Sydney Clinical School, Wolli Creek, NSW, Australia
  11. Ingham Institute of Applied Medical Research, Liverpool, NSW, Australia

Aims: As more people live longer, keeping older vulnerable people, such as those living with dementia, safe in the hospital setting is an increasing challenge. Our aim was to investigate the relationship between a history of dementia among older in-patients and the risk hospital acquired complications (HACs).

Methods: We conducted a retrospective cohort study of all older people aged ≥60 years admitted to the five hospitals across our local health district in NSW, Australia, January 2010-December 2020. Using a propensity score matched analysis and conditional logistic regression models, we explored the relationships between a history of dementia and selected HACs- falls, pressure injuries, delirium, pneumonia, venous thromboembolism (VTE), incontinence, malnutrition, and hospital mortality.

Results: Amongst 217,459 (50% women, mean age 73 years), the risk of all adverse events, except VTE and incontinence, increased with a history of dementia, compared to a matched patient without dementia  (matched for age, sex, comorbid conditions and emergency admission status): falls odds ratio (OR)=6.11, 95% confidence interval (CI) (4.88-7.66);  pressure injury OR=3.29 (95% CI 1.81 to 5.98); delirium OR = 3.11 (95% CI 2.24 to 3.91); pneumonia OR=2.19 (95% CI 1.61 to 2.99); malnutrition OR = 2.37 (1.04 to 5.43); and hospital mortality OR=1.67 (95% CI 1.48 to 1.88).

Conclusion: The higher risk of HACs observed among in-patients with dementia offers an opportunity to actively develop and implement targeted models of person-centred care to ensure the best outcomes for this vulnerable group of older adults in the hospital setting.