Dementia was associated with worse hospital outcomes: a retrospective study from Italy

Abstract   Dementia is a frequent disease in the elderly population, and its prevalence is still increasing worldwide. Amongsubjects discharged from general hospitals, the percentage of patient with dementia vary between 4 and 30%. Dementia is generally associated with higher rate of admission to hospital, increased length of hospitalization, and with an increased risk in postadmission mortality. The aim of this study was to evaluate the impact of dementia on in-hospital mortality and length of stay (LOS) in an Italian Southern Region. Data related to hospital admissions were extracted from the hospital discharge record of the Abruzzo region, considering all admissions performed during the years 2018-2023. Dementia and all comorbidities included in Charlson Comorbidity index (CCI) were extracted. To compare outcomes between patients with and without dementia, a propensity-score matching procedure performed. Unmatched patients were discarded from the analysis. Patients underwent surgical intervention were excluded. Odds ratios and their 95% confidence intervals (95% CI) for study outcomes (prolonged LOS and mortality) were performed using logistic regression models, using study outcomes as a dependent variable and COPD as an independent variable, adjusting for propensity score. Prolonged LOS was defined as a duration beyond 10 days, representing the upper quartile of distribution. During the study period, 11,231 admissions of patients with dementia were performed, over a total of 987,761. 11,231 matched controls (patients without dementia) were included. Logistic regression analyses showed that dementia disease was associated with in-hospital mortality (OR: 2.34 95%CI 2.22- 2.89) and prolonged LOS (OR: 1.66; 95%CI 1.51- 1.80). In a cohort of Italian patients, dementia was associated with in-hospital mortality and prolonged LOS. Key messages • Dementia was associated with in-hospital mortality. • Dementia was associated with prolonged length of stay.