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Master Thesis

Réhospitalisation précoce des personnes âgées après une pneumopathie aiguë : étude rétrospective en 2010 au centre hospitalier d'Annecy

Abstract : We conducted a retrospective study, among 736 patients aged 65 and older, hospitalized for acute pneumonia in the hospital of Annecy in 2010. We included the 32 unforeseen readmissions, that occurred within 30 days after discharge. Our aim is to describe the hospitalizations and the profile of concerned patients. Our sample is composed of 65,6 % men. The mean age is 79,5 years. The mean score of CIRS-G is 14,5. The mean number of geriatric syndromes is 3,8 per patient. The mean length of stay is 14,3 days. The mean PSI is 128,4. A nutritional assessment is performed for 12 patients, for whom malnutrition is diagnosed. The mean number of treatments at the discharge is 8,3. The mean time to readmission is 10,8 days. At the readmission, physicians of 53,1 % of the patients have received the summary of the first stay. Readmission, initiated by the attending physician in only one case, is related to pneumonia for 11 patients, to worsening of comorbid conditions for 12 patients. Readmissions are avoidable in ¼ of the cases. 87,5% of the avoidable readmissions are related to inadequate discharge planning. The patients, concerned by an avoidable readmission, are more often discharged near the week-end. This patients are old, frail and predominantly male. The pneumonia, motivating the initial hospitalization, are severe and responsible for prolonged stays. The screening for malnutrition seems inadequate. The intervention of the general practitioner is rare. Discharge near the week-end seems to be a potential risk factor for readmission. These observations lead us to be particularly attentive, to duration of hospital stay, comprehensive care, drug prescription, and discharge planning.
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Submitted on : Friday, January 6, 2012 - 2:52:09 PM
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Agnès Verant. Réhospitalisation précoce des personnes âgées après une pneumopathie aiguë : étude rétrospective en 2010 au centre hospitalier d'Annecy. Médecine humaine et pathologie. 2011. ⟨dumas-00657383⟩

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