| Depressive symptoms as a predictor of 6-month outcomes and services utilization in elderly medical inpatients. | |
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MedLine Citation:
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PMID: 11718593 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Depressive symptoms have been associated with higher mortality in hospitalized elderly persons, but few data are available associating depressive symptoms with other outcomes. OBJECTIVE: To determine the association between depressive symptoms and the risk of hospital readmission, nursing home admission, and death as well as inpatient services utilization during a 6-month follow-up period in a cohort of elderly medical inpatients. METHODS: We enrolled 401 patients, 75 years and older, admitted to the internal medicine service of an academic hospital in Lausanne, Switzerland. Data on demographic, medical, physical, social, and mental status were collected on admission. Depressive symptoms were defined as a score of 6 or higher on the Geriatric Depression Scale short form. Follow-up data were gathered from the centralized billing system (hospital and nursing home admissions) and from proxies (in cases of death). RESULTS: In bivariate analysis, depressive symptoms were associated with an increased risk of hospital readmission, nursing home placement, and death. After adjustment for demographic, socioeconomic, and functional status and comorbidity, depressive symptoms remained associated with an increased risk of hospital readmission (adjusted hazard ratio, 1.50; 95% confidence interval, 1.03-2.17; P =.03). In addition, depressive symptoms were associated with increased average costs of both acute and rehabilitation services, resulting in higher overall costs of inpatient services. ($175.70 vs $126.00; P<.001). This association remained after adjusting for differences in functional status, comorbidity, and living situation, although it was just short of statistical significance (P =.07). CONCLUSIONS: Elderly medical inpatients with depressive symptoms were more likely than those without to be readmitted and had higher inpatient services utilization during the follow-up period, independent of functional and health status. These results emphasize the need for interventions directed at improving management of depressive symptoms, given the low recognition and treatment rates of this problem in elderly populations. |
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Authors:
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C J Büla; V Wietlisbach; B Burnand; B Yersin |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Archives of internal medicine Volume: 161 ISSN: 0003-9926 ISO Abbreviation: Arch. Intern. Med. Publication Date: 2001 Nov |
Date Detail:
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Created Date: 2001-11-23 Completed Date: 2001-12-13 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0372440 Medline TA: Arch Intern Med Country: United States |
Other Details:
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Languages: eng Pagination: 2609-15 Citation Subset: AIM; IM |
Affiliation:
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CUTR Sylvana, Ch de Sylvana 10, 1066 Epalinges, Switzerland. Christophe.Bula@chuv.hospvd.ch |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Aged, 80 and over Cohort Studies Depression / psychology* Female Follow-Up Studies Humans Inpatients / psychology* Length of Stay Male Nursing Homes Outcome Assessment (Health Care)* Patient Participation Patient Readmission Predictive Value of Tests* Risk Factors Time Factors |
| Comments/Corrections | |
Comment In:
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Arch Intern Med. 2002 Apr 22;162(8):948-9; author reply 949
[PMID:
11966356
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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