title: Predictors of length of stay in a ward for demented elderly: gender differences.
abstract: BACKGROUND
  In our previous studies, we found both gender differences among care recipients and predictors that influenced outcomes after discharge from a ward for demented elderly. Here, we investigate predictors that influence the length of stay for each sex.
  
  
  METHODS
  We studied the data of 390 patients with dementia who were hospitalized in a ward for demented elderly between 1 April 2000 and 31 March 2008, and treated until 31 March 2009. The patients were divided into groups classified by gender. We analyzed the gender differences of characteristics and evaluated the predictors that influenced the length of stay in the ward for demented elderly using Cox's proportional hazards model. A model using the initial scores of the Revised Hasegawa Dementia Scale (HDS-R), Assessment Scale for Symptoms of Dementia (ASSD) and Nishimura's activity of daily living scale (N-ADL), which were examined on admission, was named Model 1. In Model 1, we checked the effect of each patient's characteristics, except for complications and destinations, on their length of stay. Model 2 used the final scores of HDS-R, ASSD and N-ADL including complications and destinations.
  
  
  RESULTS
  There was a clear gender difference in the length of stay. The length of stay of women was longer than that of men. It was difficult to predict the length of stay in Model 1. Age was the only predictor in women and no predictor was identified in men. In Model 2, complications and the final HDS-R and N-ADL scores were predictors of the length of stay in men. Age, complications and destinations were predictors of the length of stay in women.
  
  
  CONCLUSIONS
  It was observed that there were gender differences among predictors of the length of stay. However, it was difficult to predict the length of stay on admission. Retrospectively, the length of stay was determined by physical and psychological conditions, not by the social variables in men. In women, it was supposed that the caregiver's wish to give care at home reduced the length of stay. Besides, complication was a common predictor of the extension of stay in each sex. We have to decrease the number of complications as much as possible to reduce the length of stay.
authors.affiliation: Department of Psychiatry, Tsuruga Onsen Hospital, Tsuruga, Japan. turugaoh@poem.ocn.ne.jp
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Ono
authors.forename: Akira
authors.initials: A
authors.lastname: Tamai
authors.forename: Daisuke
authors.initials: D
authors.lastname: Takeuchi
authors.forename: Yuzuru
authors.initials: Y
authors.lastname: Tamai
authors.forename: Hidenori
authors.initials: H
authors.lastname: Iseki
authors.forename: Hiromi
authors.initials: H
authors.lastname: Fukushima
authors.forename: Sumie
authors.initials: S
authors.lastname: Kasahara
mesh_terms: D000203:Activities of Daily Living / Q000145:classification / Q000523:psychology; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000453:epidemiology / Q000523:psychology; D017028:Caregivers / Q000523:psychology; D003430:Cross-Sectional Studies; D003704:Dementia / Q000453:epidemiology* / Q000523:psychology; D015140:Dementia, Vascular / Q000453:epidemiology / Q000523:psychology; D005260:Female; D006801:Humans; D007326:Institutionalization; D007564:Japan; D053208:Kaplan-Meier Estimate; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000523:psychology; D009483:Neuropsychological Tests / Q000706:statistics & numerical data; D010351:Patient Discharge / Q000706:statistics & numerical data; D011379:Prognosis; D016016:Proportional Hazards Models; D011594:Psychometrics; D012189:Retrospective Studies; D012737:Sex Factors