Multimorbidity, consisting of a combination of chronic diseases and geriatric syndromes, predicts the risk of difficulty in discharge home in older patients admitted to acute care hospital

Abstract

AimTo determine whether multimorbidity, consisting of chronic diseases and geriatric syndromes, is associated with home discharge difficulties in older patients.MethodsA total of 522 older adults (mean age: 85 ± 7 years) who were admitted to an acute care hospital were enrolled. Multimorbidity was assessed by calculating the number of 16 chronic conditions (CCs): 8 chronic diseases (cardiac diseases, diabetes mellitus, chronic kidney disease, respiratory diseases, gastrointestinal diseases, anemia, dementia, and Parkinson disease) and 8 geriatric syndromes (depression, constipation, chronic pain, polypharmacy, dysphagia, underweight, hypoalbuminemia, and functional limitations). The patients were divided into four groups based on the number of CCs. The outcome was difficulty in discharging home (transfer to other facilities or in‐hospital death). Multivariate logistic regression analysis was performed to assess independent associations between four CC groups and failure to discharge home after adjusting for age, sex, living alone, and Barthel index and odds ratio (OR) and 95% confidence interval (CI) were calculated.ResultsOf the 522 patients, 18.8% were transferred to other facilities or died. The proportion of poor outcome in those with 0–2, 3–4, 5–6, and ≥7 CCs was 4.4%, 14.8%, 25.5%, and 37.5%, respectively. Logistic regression analysis after adjusting for covariates revealed that multimorbidity increased the risk of difficulty in discharging home (OR, 2.9 [95% CI, 1.1–8.0] for 3–4 CCs; OR, 4.9 [95% CI, 1.8–13.5] for 5–6 CCs; OR, 8.7 [95% CI, 3.1–24.6] for ≥7 CCs).ConclusionMultimorbidity, consisting of chronic diseases and geriatric syndromes, predicted difficulty in discharge home in older patients. Geriatr Gerontol Int 2023; ••: ••–••.