title: [Cognitive-behavioral specialized units: predictive factors of readmissions within three months].
abstract: BACKGROUND
  Behavioral and psychological symptoms of dementia (BPSD) are frequent and belong to the natural evolution of the disease. Specialized cognitive-behavioral units (Unités cognitivo-comportementales) were created, in France (plan Alzheimer 2008-2012), to cope with this problem. Despite a stay in such a unit, some patients have to be rehospitalized. The main aim of the current study was to highlight the predictive factors of readmissions.
  
  
  METHODS
  Descriptive, retrospective study of demented patients ≥75 years, hospitalized between January 2010 and April 2011. We compared patients that had to be rehospitalized within 3 months (group 1), with the patients that did not need to be rehospitalized or after 3 months of time (group 2). Patients characteristics included: basic daily living activities (French GIR score), MMSE score, neuropsychiatric inventory score, type of BPSD, length of stay and antipsychotropic drugs.
  
  
  RESULTS
  Two hundred thirty-five patients were included including, 147 women (62.5%), with mean age of 82.74±7.13 years. SPCD was the main reason for hospitalization. Thirty patients (12.77%) belonged to group 1. The mean number of psychotropic treatments increased during the stay (p=0.02), particularly in group 2 (p=0.01). The NPI score decreased during the hospitalization in both groups. Linear regression analysis showed that behavioral type of symptoms (OR: 3.18; 95% CI 1.32-7.65) and association of antidepressant and antipsychotic drugs (OR: 4.77; 95% CI 1.35-16.83) were significantly predictive of an early readmission. The risk of readmission also significantly decreased as the length of stay increased.
  
  
  CONCLUSIONS
  This work confirms the specificity and the need for such units. The results will help improving the outcome of demented patients with BPSD and treated with different antipsychotropic drugs.
authors.affiliation: Centre mémoire de ressources et de recherche, CHU La Milétrie, Poitiers, France.
authors.forename: Céline
authors.initials: C
authors.lastname: Baudemont
authors.forename: Isabelle
authors.initials: I
authors.lastname: Merlet
authors.forename: Foucaud
authors.initials: F
authors.lastname: du Boisgueheneuc
authors.forename: Évelyne
authors.initials: É
authors.lastname: Liuu
authors.forename: Florence
authors.initials: F
authors.lastname: Tartarin
authors.forename: Stéphanie
authors.initials: S
authors.lastname: Ragot
authors.forename: Marc
authors.initials: M
authors.lastname: Paccalin
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D015928:Cognitive Behavioral Therapy / Q000458:organization & administration*; D005260:Female; D005602:France; D006757:Hospital Units / Q000458:organization & administration*; D006801:Humans; D008297:Male; D010359:Patient Readmission / Q000706:statistics & numerical data*; D011379:Prognosis; D012307:Risk Factors; D012920:Social Behavior Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*