Home Discharge Down, Mortality Increased After ICU Stay for Dementia Patients

MONDAY, July 17, 2023 (HealthDay News) -- Older adults with Alzheimer disease and related dementia (ADRD) have lower home discharge rates and increased mortality after intensive care unit (ICU) admission, according to a study published in the July 1 issue of the American Journal of Critical Care.

Mary Lynn Davis-Ajami, Ph.D., R.N., from Merrimack College in North Andover, Massachusetts, and colleagues conducted an observational study using the Optum Clinformatics Data Mart Database from 2016 to 2019 for adults older than 67 years with a first ICU admission in 2018. Discharge location and subsequent mortality were compared between patients with and without ADRD.

Data were included for 145,342 adults, of whom 10.5 percent had ADRD and were more likely to be older, to be female, and to have more comorbid conditions. The researchers found that 37.6 and 68.6 percent of patients with ADRD and those without ADRD were discharged home (odds ratio, 0.40), respectively. Patients with ADRD had increased odds of death in the same month as discharge (19.9 versus 10.3 percent) and death in the 12 months after discharge (50.8 versus 26.2 percent) compared with those without ADRD (odds ratios, 1.54 and 1.95, respectively).

"The lower home discharge and higher mortality rates after an ICU admission in patients with ADRD, as compared with the rates for the general ICU patient population, are cause for concern," the authors write. "Although beyond the scope of this study, these observations raise questions about whether treatment plans should be adjusted proactively to include strategies to diminish the likelihood of an ICU admission."

One author disclosed ties to the pharmaceutical and medical technology industries; a second author serves on a discussion group, without receiving pay, organized by Janssen.

Abstract/Full Text