Care home residents admitted to hospital through the emergency pathway: characteristics and associations with inpatient mortality

• Published in: The Journal of the Royal College of Physicians of Edinburgh 2018-09, Vol.48 (3), p.202-209
• Main Authors: Keevil, V L, Martin, G J, Biram, R, Wallis, S, Romero-Ortuno, R
• Format: Article
• Language: English
• ISSN: 1478-2715; 2042-8189
• DOI: 10.4997/JRCPE.2018.303

Routinely collected hospital information could help to understand the characteristics and outcomes of care home residents admitted to hospital as an emergency. This retrospective 2-year service evaluation included first emergency admissions of any older adult (≥75 years) presenting to Cambridge University Hospital. Routinely collected patient variables were captured by an electronic patient record system. Care home status was established using an official register of care homes. 7.7% of 14,777 admissions were care home residents. They were older, frailer, more likely to be women and have cognitive impairment than those admitted from their own homes. Additionally, 42% presented with an Emergency Department Modified Early Warning Score above the threshold triggering urgent review, compared to 26% of older adults from their own homes. Admission from a care home was associated with higher 30-day inpatient mortality (11.1 vs 5.7%), which persisted after multivariable adjustment (hazard ratio: 1.42; 95% confidence interval: 1.09-1.83; p = 0.008). Care home residents admitted to hospital as an emergency have high illness acuity and inpatient mortality.