@article{4b765a5c05c8414caf18bbb22ab35a56,
title = "The risk of death within 5 years of first hospital admission in older adults",
abstract = "Background: The risk of death in people after their first admission to hospital or first presentation to the emergency department for any reason is not known. The objective of this study was to estimate the risk of death among older adults who had had no admissions to hospital or emergency department visits in the preceding 5 years. Methods: We used administrative data from Ontario, Canada, from 2007 to 2017 to measure the 5-year risk of death in community-dwelling adults aged 66 years and older after their first planned or unplanned hospital admission or emergency department visit, and among those who were neither admitted to hospital nor presented to the emergency department. We describe how this risk varied by age. Results: Among 922074 communitydwelling older adults, 12.7% died (116940 deaths) over a follow-up of 3112528 person-years (standardized mortality rate 53.8 per 1000 person-years). After the first unplanned hospital admission, 39.7% died (59234 deaths, standardized mortality rate 127.6 per 1000 personyears). After the first planned hospital admission, 13.0% died (10 775 deaths, standardized mortality rate 44.6 per 1000 person-years). After the first visit to the emergency department, 10.9% died (35663 deaths, standardized mortality rate 36.2 per 1000 person-years). Among those with neither an emergency department visit nor hospital admission during follow-up, 3.1% died (11268 deaths, standardized mortality rate 29.6 per 1000 person-years). Slightly more than half of all deaths were in those with first unplanned hospital admission (50.7%). Interpretation: Death within 5 years of first unplanned hospital admission for older adults is frequent and common. Knowledge of this risk may influence counselling and patient preferences and may be useful in research and analyses for health system planning.",
author = "Quinn, {Kieran L.} and Stall, {Nathan M.} and Zhan Yao and Stukel, {Therese A.} and Peter Cram and Detsky, {Allan S.} and Bell, {Chaim M.}",
note = "Funding Information: This study was funded by a Physician Services Incorporated Resident Research Grant, and by the Sinai Health System Research Foundation Fund. Kieran Quinn and Nathan Stall receive funding from the Canadian Institutes of Health Research Vanier Scholarship Program, the Eliot Phillipson Clinician-Scientist Training Program and the Clinician Investigator Program at the University of Toronto. Peter Cram holds grant funding from the US National Institutes of Health.*%blankline%**%blankline%* Funding Information: Disclaimer: Nathan Stall is an associate editor for CMAJ and was not involved in the editorial decision-making process for this article. This study was supported by ICES, which is funded by an annual grant from the Ontario Ministry of Health and Long-Term Care (MOHLTC). The opinions, results and conclusions reported in this paper are those of the authors and are independent from the funding sources. No endorsement by ICES or the Ontario MOHLTC is intended or should be inferred. Parts of this material are based on data and information compiled and provided by the Canadian Institute for Health Information (CIHI). However, the analyses, conclusions, opinions and statements expressed herein are those of the author, and not necessarily those of CIHI. We thank IMS Brogan Inc. for use of their Drug Information Database. Funding Information: Funding: This study was funded by a Physician Services Incorporated Resident Research Grant, and by the Sinai Health System Research Foundation Fund. Kieran Quinn and Nathan Stall receive funding from the Canadian Institutes of Health Research Vanier Scholarship Program, the Eliot Phillipson Clinician-Scientist Training Program and the Clinician Investigator Program at the University of Toronto. Peter Cram holds grant funding from the US National Institutes of Health. Publisher Copyright: {\textcopyright} 2019 Joule Inc.",
year = "2019",
month = dec,
day = "16",
doi = "10.1503/cmaj.190770",
language = "English (US)",
volume = "191",
pages = "E1369--E1377",
journal = "CMAJ",
issn = "0820-3946",
publisher = "Canadian Medical Association",
number = "50",
}