Geriatric Disorder Clinical Trial
Official title:
Risks of Death, Hospital Readmission, and Institutionalization After Hospitalization in Acute Geriatric Unit
Three events can be considered of major importance for patients after a hospitalization in an
AGU: death, hospital readmission, and institutionalization. Current published data do not
allow the clinician to simultaneously estimate the risk of hospital readmission,
institutionalization and death of an older patient according to his/her characteristics and
various complications that occurred during the hospitalization. However, clinicians often
need to estimate these risks at hospital discharge to adapt their therapeutic choices, their
proposals post-hospital care, and provide reliable and fair information to the patient and
his relatives.
Estimating simultaneously the hazard for each of these three events can be complex. Indeed, a
death event hinder the observation of re-hospitalization or institutionalization if death
occurs before these events. The death should be considered a competing risk in these
analyzes. Hospital readmission may modify the risk of death or institutionalization and
should be considered as an intermediate factor for these event. This complexity cannot be
accounted with classical statistical models, like logistic regression models.
The purpose of this study is to use more appropriate statistical models (multi-state models)
to better estimate simultaneously the risks of hospital readmission, institutionalization,
and death of a patient given after hospitalization in AGU, and to show that accuracy of these
estimations can be improved by taking into account complications that occurred during the
stay in AGU.
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