title: Discharge diagnosis and comorbidity profile in hospitalized older patients with dementia.
abstract: OBJECTIVE
  The aim of this study was to investigate the principal discharge diagnosis and related comorbidity in hospitalized older patients affected by dementia.
  
  
  METHODS
  Data from 51,838 consecutive computerized discharge records of the St. Anna University Hospital (Ferrara, Italy) were analyzed. Records included only subjects aged ≥60 years. Number of admissions, length of stay in hospital, primary and secondary discharge diagnosis (by ICD-9-CM code), number of procedures, and possible death were evaluated.
  
  
  RESULTS
  Demented patients represented 8.6% of the sample (4466 individuals) and were older and more likely to be female patients compared with controls (47,372 individuals); they were characterized by higher number of admissions to hospital, instrumental clinical investigations, secondary diagnoses, and mortality rate. Among the primary diagnoses, a higher prevalence of cerebrovascular disease, pneumonia, and hip fracture was observed in demented patients. Furthermore, pulmonary embolism, renal failure, septicemia, and urinary infections were frequently reported in demented patients, but not in controls. As regards secondary diagnoses, dementia was associated with an increased risk of delirium, muscular atrophy and immobilization, dehydration, cystitis, and pressure ulcers, whereas the risk for other conditions, including cancer, was reduced.
  
  
  CONCLUSIONS
  Among older patients, dementia was associated with higher rate of admissions to hospital and mortality. Discharge diagnoses were sensibly different according to the presence of dementia; in particular, a greater load and a different kind of comorbidity were observed in demented patients. On the whole, our data suggest that the adequate management of demented outpatients might help to reduce hospitalization.
authors.affiliation: Department of Clinical and Experimental Medicine, Section of Internal Medicine, Gerontology & Geriatrics, University of Ferrara, Ferrara, Italy. gzuliani@hotmail.com
authors.forename: Giovanni
authors.initials: G
authors.lastname: Zuliani
authors.forename: Matteo
authors.initials: M
authors.lastname: Galvani
authors.forename: Fotini
authors.initials: F
authors.lastname: Sioulis
authors.forename: Francesco
authors.initials: F
authors.lastname: Bonetti
authors.forename: Stefano
authors.initials: S
authors.lastname: Prandini
authors.forename: Benedetta
authors.initials: B
authors.lastname: Boari
authors.forename: Franco
authors.initials: F
authors.lastname: Guerzoni
authors.forename: Massimo
authors.initials: M
authors.lastname: Gallerani
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D003704:Dementia / Q000175:diagnosis* / Q000453:epidemiology* / Q000401:mortality; D005260:Female; D017052:Hospital Mortality; D006760:Hospitalization / Q000706:statistics & numerical data*; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D007558:Italy / Q000453:epidemiology; D007902:Length of Stay; D008297:Male; D016017:Odds Ratio; D010351:Patient Discharge / Q000706:statistics & numerical data*; D015995:Prevalence