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  • Potentially preventable complications of urinary tract infections, pressure areas, pneumonia, and delirium in hospitalised dementia patients: retrospective cohort study

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Potentially preventable complications of urinary tract infections, pressure areas, pneumonia, and delirium in hospitalised dementia patients: retrospective cohort study
  1. Kasia Bail1,
  2. Helen Berry2,
  3. Laurie Grealish1,
  4. Brian Draper3,
  5. Rosemary Karmel4,
  6. Diane Gibson1,
  7. Ann Peut5
  1. 1Faculty of Health, University of Canberra, Canberra, Australian Capital Territory, Australia
  2. 2Centre for Research and Action in Public Health, The University of Canberra, Canberra, Australian Capital Territory, Australia
  3. 3University of New South Wales, Academic Department for Old Age Psychiatry, Euroa Centre, Prince of Wales Hospital, Randwick, New South Wales, Australia
  4. 4Data Linkage Unit, Australian Institute of Health and Welfare, Canberra, Australian Capital Territory, Australia
  5. 5Ageing and Aged Care, Australian Institute of Health and Welfare, Canberra, Australian Capital Territory, Australia
  1. Correspondence to Dr Kasia Bail; kasia.bail{at}canberra.edu.au

Abstract

Objectives To identify rates of potentially preventable complications for dementia patients compared with non-dementia patients.

Design Retrospective cohort design using hospital discharge data for dementia patients, case matched on sex, age, comorbidity and surgical status on a 1 : 4 ratio to non-dementia patients.

Setting Public hospital discharge data from the state of New South Wales, Australia for 2006/2007.

Participants 426 276 overnight hospital episodes for patients aged 50 and above (census sample).

Main outcome measures Rates of preventable complications, with episode-level risk adjustment for 12 complications that are known to be sensitive to nursing care.

Results Controlling for age and comorbidities, surgical dementia patients had higher rates than non-dementia patients in seven of the 12 complications: urinary tract infections, pressure ulcers, delirium, pneumonia, physiological and metabolic derangement (all at p<0.0001), sepsis and failure to rescue (at p<0.05). Medical dementia patients also had higher rates of these complications than did non-dementia patients. The highest rates and highest relative risk for dementia patients compared with non-dementia patients, in both medical and surgical populations, were found in four common complications: urinary tract infections, pressure areas, pneumonia and delirium.

Conclusions Compared with non-dementia patients, hospitalised dementia patients have higher rates of potentially preventable complications that might be responsive to nursing interventions.

  • Health Services Administration & Management

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/2.0/ and http://creativecommons.org/licenses/by-nc/2.0/legalcode.

http://dx.doi.org/10.1136/bmjopen-2013-002770

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