Incidence and outcome of interrupted geriatric rehabilitation requiring acute hospital transfer
Background and aims
Elderly rehabilitation programs provide a period of rehabilitation to optimize a safe home discharge after acute hospitalization of older adults. Often, these patients may have their rehabilitation interrupted when they become unwell and subsequently require transfer back to an acute hospital setting. We will look at the incidence and outcome of this interruption. This paper aimed to determine the incidence of interrupted post-acute geriatric rehabilitation requiring acute hospital transfer and to analyze the outcome of the transfers.
An analysis of a retrospective cohort of elderly patients admitted into a 22-bed community-based geriatric rehabilitation unit over a 48-month period.
Five hundred thirty-nine patients were admitted for rehabilitation. Fifty (9.3%) patients had their rehabilitation interrupted and were transferred to an acute hospital setting. Sixty-six percent were females; mean age 82.1 ± 8.7 years. Final diagnosis was acute severe infections (44%), traumatic fracture secondary to fall (10%), intraabdominal complications (10%), cardiac complications (8%), and acute neurological event (6%). Of these patients, 42% had a fatal outcome while 32% returned for rehabilitation.
Interrupted geriatric rehabilitation requiring acute hospital transfer occurred in 9.3% of patients; acute severe infection was the most common cause. These transfers were associated with significant mortality. Rehabilitation programs should focus improvement efforts on identifying suitable patients for rehabilitation, optimizing care transitions, and minimizing rates of transfers.
KeywordsComorbidity Elderly Patient transfer Rehabilitation
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
For this type of study, formal consent is not required.
For this service evaluation study, ethical approval was not required in our institution.
- 2.Health Service Executive, Royal College of Physicians of Ireland (2011) National Clinical Programme for older people: special geriatric services model of care. Dublin. Available at http://hdl.handle.net/10147/324959. Accessed 10 March 2018
- 3.Osuafor CN, Salawu A, McCarthy F (2018) A retrospective audit of an elderly rehabilitation service. How effective are we? Ir Med J 111(8):810Google Scholar
- 5.O’Toole R, O’Neill D, Collins R et al (2012) Risk of rehospitalisation from an “off-site” rehabilitation unit for older adults. Ir Med J 105(8):285Google Scholar
- 10.Heim N, Rolden H, van Fenema EM, Weverling - Rijnsburger AWE, Tuijl JP, Jue P, Oleksik AM, de Craen AJM, Mooijaart SP, Blauw GJ, Westendorp RGJ, van der Mast RC, van Everdinck IEC (2016) The development, implementation and evaluation of a transitional care programme to improve outcomes of frail older patients after hospitalization. Age Ageing 45:642–651CrossRefGoogle Scholar