Survival After Multiple Hospitalizations for Infections and Dehydration in Nursing Home Residents With Advanced Cognitive Impairment | Acid Base, Electrolytes, Fluids | JAMA | JAMA Network
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Research Letter
July 17, 2013

Survival After Multiple Hospitalizations for Infections and Dehydration in Nursing Home Residents With Advanced Cognitive Impairment

Author Affiliations
  • 1Health Services, Policy, and Practice, Warren Alpert School of Medicine of Brown University, Providence, Rhode Island
  • 2Hebrew SeniorLife, Institute for Aging Research, Boston, Massachusetts
JAMA. 2013;310(3):319-320. doi:10.1001/jama.2013.8392

Multiple hospitalizations for complications from a terminal illness may be burdensome for elderly patients and reflect poor quality care. Infections and eating problems are 2 such complications characterizing the final stage of dementia.1

In a previous study,1 burdensome health care transitions were defined as 2 or more hospitalizations for infections or dehydration during the last 90 days of life in nursing home (NH) residents with advanced cognitive impairment. The objective of this study was to examine a related issue: whether the occurrence of multiple hospitalizations for these complications was associated with survival.

The study population was identified using data from the national Minimum Data Set repository,2 which includes standardized assessments regularly completed by staff on all NH residents in the United States between January 1, 2000, and December 31, 2008. We identified the first baseline assessment in which a resident had a Cognitive Performance Score3 of 4, 5, or 6, indicating moderate to very severe cognitive impairment.

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