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Hospital admissions and mortality over 20 years in community-dwelling older people: findings from the Hertfordshire Cohort Study

Hospital admissions and mortality over 20 years in community-dwelling older people: findings from the Hertfordshire Cohort Study
Hospital admissions and mortality over 20 years in community-dwelling older people: findings from the Hertfordshire Cohort Study

Background: demographic changes worldwide are leading to pressures on health services, with hospital admissions representing an important contributor. Here, we report admission types experienced by older people and examine baseline risk factors for subsequent admission/death, from the community-based Hertfordshire Cohort Study. 

Methods: 2997 participants (1418 women) completed a baseline questionnaire and clinic visit to characterize their health. Participants were followed up from baseline (1998–2004, aged 59–73 years) until December 2018 using UK Hospital Episode Statistics and mortality data, which report clinical outcomes using ICD-10 coding. Baseline characteristics in relation to the risk of admission/death during follow-up were examined using sex-stratified univariate logistic regression. 

Results: during follow-up, 36% of men and 26% of women died and 93% of men and 92% of women had at least one hospital admission; 6% of men and 7% of women had no admissions and were alive at end of follow-up. The most common types of admission during follow-up were cardiovascular (ever experienced: men 71%, women 68%) and respiratory (men 40%, women 34%). In both sexes, baseline risk factors that were associated (p < 0.05) with admission/death during follow-up were older age, poorer SF-36 physical function, and poorer self-rated health. In men, manual social class and a history of smoking, and in women, higher BMI, not owning one’s home, and a minor trauma fracture since age 45, were also risk factors for admission/death. 

Conclusions: sociodemographic factors were related to increased risk of admission/death but a small proportion experienced no admissions during this period, suggesting that healthy ageing is achievable.

Ageing, Epidemiology, Hospitalisation, Mortality, Risk factor
1594-0667
2751-2757
Rambukwella, Roshan
6d02df52-faae-4549-a798-c0211eafe905
Westbury, Leo D.
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Pearse, Camille
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Ward, Kate A.
39bd4db1-c948-4e32-930e-7bec8deb54c7
Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
Dennison, Elaine M.
ee647287-edb4-4392-8361-e59fd505b1d1
Rambukwella, Roshan
6d02df52-faae-4549-a798-c0211eafe905
Westbury, Leo D.
5ed45df3-3df7-4bf9-bbad-07b63cd4b281
Pearse, Camille
9730e5c3-0382-4ed7-8eaa-6932ab09ec15
Ward, Kate A.
39bd4db1-c948-4e32-930e-7bec8deb54c7
Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
Dennison, Elaine M.
ee647287-edb4-4392-8361-e59fd505b1d1

Rambukwella, Roshan, Westbury, Leo D., Pearse, Camille, Ward, Kate A., Cooper, Cyrus and Dennison, Elaine M. (2023) Hospital admissions and mortality over 20 years in community-dwelling older people: findings from the Hertfordshire Cohort Study. Aging Clinical and Experimental Research, 35 (11), 2751-2757. (doi:10.1007/s40520-023-02554-0).

Record type: Article

Abstract

Background: demographic changes worldwide are leading to pressures on health services, with hospital admissions representing an important contributor. Here, we report admission types experienced by older people and examine baseline risk factors for subsequent admission/death, from the community-based Hertfordshire Cohort Study. 

Methods: 2997 participants (1418 women) completed a baseline questionnaire and clinic visit to characterize their health. Participants were followed up from baseline (1998–2004, aged 59–73 years) until December 2018 using UK Hospital Episode Statistics and mortality data, which report clinical outcomes using ICD-10 coding. Baseline characteristics in relation to the risk of admission/death during follow-up were examined using sex-stratified univariate logistic regression. 

Results: during follow-up, 36% of men and 26% of women died and 93% of men and 92% of women had at least one hospital admission; 6% of men and 7% of women had no admissions and were alive at end of follow-up. The most common types of admission during follow-up were cardiovascular (ever experienced: men 71%, women 68%) and respiratory (men 40%, women 34%). In both sexes, baseline risk factors that were associated (p < 0.05) with admission/death during follow-up were older age, poorer SF-36 physical function, and poorer self-rated health. In men, manual social class and a history of smoking, and in women, higher BMI, not owning one’s home, and a minor trauma fracture since age 45, were also risk factors for admission/death. 

Conclusions: sociodemographic factors were related to increased risk of admission/death but a small proportion experienced no admissions during this period, suggesting that healthy ageing is achievable.

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Accepted/In Press date: 25 August 2023
Published date: November 2023
Additional Information: Funding Information: The authors were supported by the UK Medical Research Council [MC_PC_21003; MC_PC_21001]. The Hertfordshire Cohort Study was supported by the Medical Research Council University Unit Partnership grant number MRC_MC_UP_A620_1014. Publisher Copyright: © 2023, The Author(s).
Keywords: Ageing, Epidemiology, Hospitalisation, Mortality, Risk factor

Identifiers

Local EPrints ID: 482335
URI: http://eprints.soton.ac.uk/id/eprint/482335
ISSN: 1594-0667
PURE UUID: 184d512e-2970-4bde-b176-8d34ea952568
ORCID for Leo D. Westbury: ORCID iD orcid.org/0009-0008-5853-8096
ORCID for Kate A. Ward: ORCID iD orcid.org/0000-0001-7034-6750
ORCID for Cyrus Cooper: ORCID iD orcid.org/0000-0003-3510-0709
ORCID for Elaine M. Dennison: ORCID iD orcid.org/0000-0002-3048-4961

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Date deposited: 26 Sep 2023 17:07
Last modified: 18 Mar 2024 03:34

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Contributors

Author: Roshan Rambukwella
Author: Leo D. Westbury ORCID iD
Author: Camille Pearse
Author: Kate A. Ward ORCID iD
Author: Cyrus Cooper ORCID iD

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