The risk for poor health in older patients continues for months after hospitalization for heart failure, acute myocardial infarction, or pneumonia, according to a report published February 6 online ahead of print in BMJ.
Previous research has shown that patients are at high risk for readmission to the hospital and death in the month after discharge for a range of conditions. However, lead author Kumar Dharmarajan, MD, and colleagues found that this risk remains elevated for as much as a year following hospitalization for heart failure, acute myocardial infarction, or pneumonia, although the risk declines slowly. They also found that the risk of rehospitalization remained elevated for all three conditions for a longer period than risk of death.
“Although prolongation of risk is most pronounced after hospitalization for heart failure, patients admitted with any of the three conditions are at considerably higher risk of adverse outcomes than the general elderly population for the full year after hospital discharge,” Dr. Dharmarajan and colleagues wrote.
“Yet risk ultimately plateaus by seven weeks after discharge, suggesting that patients reaching this point without having been readmitted may have entered a new and less vulnerable stage of recovery.”
The researchers studied more than three million Medicare fee-for-service beneficiaries, aged 65 years or older, in the year after hospitalization for heart failure, acute myocardial infarction, or pneumonia. Within one year of being discharged from the hospital for heart failure, 67.4% of patients were readmitted to the hospital and 35.8% died.
Among patients discharged after a hospitalization for acute myocardial infarction, 49.9% were readmitted within one year and 25.1% died. In those patients surviving pneumonia, 55.6% were rehospitalized and 31.1% died within the following year.
In the first 90 days, patients hospitalized for these three conditions were more likely than the general older population to be readmitted to the hospital (eight times more likely for heart failure, six times for acute myocardial infarction, and six times for pneumonia) or die (11 times more likely for heart failure, eight times for acute myocardial infarction, and 10 times for pneumonia).