Predictors for return to own home and being alive at 6 months after nursing home intermediate care following acute hospitalization

Purpose: To investigate factors associated with ability to return home and being alive at 6 months, in a population of older community living patients selected for nursing home intermediate care after acute hospitalization. Methods: Prospective observational cohort study carried out between June 2011 and December 2012. Demographic and clinical information, comprehensive geriatric assessment (CGA) and patient outcomes were registered on consecutive patients admitted from both orthopaedic and medical hospital departments. Results: Five hundred and fifty-seven patients were included, median age was 86 years. Three hundred and forty (61%) patients had a medical and 217 (39%) an orthopaedic admission diagnosis. Median length of stay was 14 days. Eighty percent of the patients were able to return home and 89% were alive at 6 months. Low Timed up and go (TUG), indicating better physical function and high score on Barthel Index (BI) and Mini-Mental Status Examination (MMSE) were significantly associated with the ability to return home. A low level of the cardiac failure marker N-terminal pro-brain natriuretic hormone (NTpro-BNP) was significantly associated with being alive at 6 months. Conclusions: In post-acute intermediate care in nursing home, significant differences were demonstrated between patients concerning the ability to return home and being alive at 6 months. A low TUG, high BI and high MMSE were significantly related to the ability to return home while low NTpro-BNP was an independent predictor for being alive at 6 months. (C) 2013 Elsevier Masson SAS and European Union Geriatric Medicine Society. All rights reserved.