[Early rehospitalization of persons aged 75 years or older admitted to a post-emergency general medicine department: Rates and predictive factors]

Introduction: Given the implications of rehospitalization at the individual and societal level, it seems important to identify elderly persons (EP) at risk. We analyzed the predictive factors of early rehospitalization in EP aged 75 years or more hospitalized in a medicine department.

Methods: A single-center retrospective study that included EP aged 75 years or more hospitalized in a polyvalent medical department following an emergency admission. Patients who died during the hospitalization, who had been transferred or hospitalized during the previous month, were excluded. The impact of sociodemographic, administrative and biomedical data on rehospitalization at one month was analyzed.

Results: A total of 319 hospitalizations were collected (mean age of patients: 84.7±5.7 years). Most lived at home (80.2%) and among these 8.4% had no home help. The rehospitalization rate was 16.3%, among which 2/3 were related to the reason for the initial hospitalization. Among the predictive factors found in the univariate analysis (male sex, multiple diseases, polypharmacy, multiple hospitalizations, cognitive disorders and calls to emergency services), only the presence of at least two previous hospitalizations in the year (odds ratio [OR]=2.10; 95% confidence interval [95%CI] [1.01-4.39]; P=0.048) and the presence of confusion without dementia (OR=3.78; IC 95% [1.09-13.06]; P=0.04) were significant. Discharge to a rehabilitation unit and increased support at home did not affect the likelihood of rehospitalization.

Conclusion: The rehospitalization of EP is frequent and difficult to anticipate because there are few predictors and their impact is weak. The most important factors were medical: multiple hospitalizations and confusion without dementia.