Abstract
Background
In spite of a rapidly ageing population, there is a lack of population-based data on mortality among nursing home residents in Southern Europe.
Aims
To assess mortality rates, their determinants, and causes of death in newly admitted nursing home residents in the Veneto region (northeastern Italy).
Methods
19,392 subjects aged ≥ 65 years admitted to regional nursing homes during 2015–2017 were recruited in a cohort mortality study based on linked health records. Risk factors for mortality were investigated by Cox regression. The distribution of causes of death was retrieved from death certificates.
Results
Mortality peaked in the first 4 months after admission; thereafter the monthly mortality rate fluctuated around 3% in males and 2% in females. Overall mortality was 23% at 6 months and 34% at 1 year. In addition to age, gender, and dependency, main risk factors for mortality were recent hospitalization (first 4 months after entry into the facility), and the burden of comorbidities (subsequent follow-up period). The most represented causes of mortality were similar in the first and in the subsequent period after admission: cardio-cerebrovascular diseases, neurodegenerative diseases, respiratory diseases, and infections.
Discussion
The first months after admission represent a period at high risk of mortality, especially for patients with a recent hospitalization. Causes reported in death certificates suggest mainly an acute deterioration of pre-existing chronic conditions.
Conclusion
Health care plans should be personalized for newly admitted vulnerable patients. Palliative care needs should be recognized and addressed for high-risk non-cancer patients.
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Conception and design: MB, MCC, and UF. Acquisition and analysis of data: MB, MP, VZ, and MRL. Interpretation of data: CB, PG, MCC, and UF. Drafting of the manuscript: UF. Critical revision of manuscript for important intellectual content: MB, MP, CB, PG, MCC, VZ, and MRL. All authors approved the final manuscript.
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Since all analyses involved routinely collected anonymized records, the study was deemed exempt from approval by the local ethical committee.
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Braggion, M., Pellizzari, M., Basso, C. et al. Overall mortality and causes of death in newly admitted nursing home residents. Aging Clin Exp Res 32, 275–280 (2020). https://doi.org/10.1007/s40520-019-01441-x
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DOI: https://doi.org/10.1007/s40520-019-01441-x