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J. Robles-Suarez, L.D. Sinvani, L. Rosen, C.N. Nouryan, G. Wolf-Klein

Jour Nursing Home Res 2015;1:11-14

Background: Today, up to 90% of rehospitalizations from long term care (LTC) facilities appear to be unplanned. Studies have found laboratory values indicating low levels of hydration in as many as 48% to 60% of subjects in both hospitalized and community-dwelling older adults. Objectives: This study's objective was to identify the prevalence of low hydration, a potentially treatable condition, in patients who were rehospitalized from a LTC facility. Design: This was a retrospective chart review of patients rehospitalized within 30 days of LTC facility admission. For this study, low hydration was defined as a Serum Na >145 mg/dl or a blood urea nitrogen to creatinine (BUN:Cr) ratio of > 20:1. Setting: A hospital and a nearby LTC facility in the metropolitan New York area. Participants: Any patient over age 65 who was sent back to the hospital for any reason within 30 days of entering the LTC facility. Measurements: demographics, admission diagnosis, co-morbid conditions, electrolyte changes (Na, BUN, and Cr), and reason for transfer. Results: There were 261 subjects rehospitalized during the six-month study period. Average age was 79 years, and 42% were male. The principal diagnoses at LTC admission were: cardiovascular (34%), infection (20%), neurological (14%), gastrointestinal (13%), gynecological (4%), pulmonary (3%), fall (2%), electrolyte abnormality (including documented dehydration, 2%), hematology (1%) and other (6%). For these subjects, the prevalence of low hydration at time of LTC facility admission was 60.5% (95% CI: 54.3% to 66.5%), at time of rehospitalization, low hydration prevalence had increased to 67.4% (95% CI: 61.4% to 73.1%). Conclusion: Low hydration appears to be an unrecognized clinical issue for older adults requiring LTC and hospital readmission. Increasing awareness of this condition might assist in improving the patient's fluid status prior to discharge from the hospital thereby potentially preventing avoidable readmissions.

J. Robles-Suarez ; L.D. Sinvani ; L. Rosen ; C.N. Nouryan ; G. Wolf-Klein (2015): Hydration Status of Long Term Care Residents Rehospitalized Within 30 Days of Hospital Discharge. The Journal of Nursing Home Research Science (JNHRS). http://dx.doi.org/10.14283/jnhrs.2015.3


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