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. 2013 Mar 23;3(1):86-95.
doi: 10.1159/000350028. Print 2013 Jan.

Predictors of time to discharge in patients hospitalized for behavioral and psychological symptoms of dementia

Affiliations

Predictors of time to discharge in patients hospitalized for behavioral and psychological symptoms of dementia

Tatsuru Kitamura et al. Dement Geriatr Cogn Dis Extra. .

Abstract

Background/aims: In Japan, more than 50,000 patients with dementia are housed in psychiatric facilities, a trend precipitated by prolonged hospitalizations. This study aimed to determine predictors for the time to discharge in patients hospitalized for behavioral and psychological symptoms of dementia (BPSD).

Methods: Medical charts of patients admitted to an acute psychogeriatric ward for treatment of BPSD were reviewed. Cox's proportional hazards model was used to evaluate relationships between active behavioral problems and/or demographics at the time of admission, and the time until favorable discharge (FD), defined as discharge to the patient's own home or a care facility.

Results: For the 402 study patients included in this study, median time to FD was 101 days. In addition to family and residential factors, multivariate analysis identified higher Mini-Mental State Examination scores as independent clinical predictors for a shorter hospital stay, whereas male gender and combative behavior as the primary reason for hospital admission were predictors for a longer hospital stay.

Conclusion: Clinical characteristics can be predictive of the time to discharge for patients with BPSD. Earlier interventions and enhanced care strategies may be needed for patients with a lower likelihood of FD.

Keywords: Behavioral disorders; Dementia; Length of hospitalization; Patient care management; Predictors; Psychiatric symptoms.

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Figures

Fig. 1
Fig. 1
Cumulative probability of hospital stay in patients with BPSD.
Fig. 2
Fig. 2
CART analysis for time to FD. n = Number of observations; HR = hazard ratio.

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