title: Severity of White Matter Hyperintensities and Length of Hospital Stay in Patients with Cognitive Impairment: A CREDOS (Clinical Research Center for Dementia of South Korea) Study.
abstract: OBJECTIVE
  White matter hyperintensities (WMHs) contribute to aggravation of dementia or geriatric syndrome, thereby resulting in functional impairment. However, evidence of direct association between WMHs and medical resource utilization indicated by length of hospital stay (LOS) is scarce in patients with cognitive impairment. This study aimed to examine the relationship between the severity of WMHs and LOS in patients with cognitive impairment.
  
  
  METHODS
  4,253 older adults with cognitive impairment were enrolled in this study. We defined LOS as the total sum of days from January 1, 2008 to December 31, 2012. The severity of periventricular (PVWMHs), deep (DWMHs), and overall white matter hyperintensities (Overall WMHs) was evaluated by a visual rating scale. We conducted multinomial logistic regression to demonstrate the relationship between LOS and severity of PVWHMs, DWHMs, and Overall WMHs, respectively.
  
  
  RESULTS
  The median LOS was 20 days. Severe PVWMHs had a higher likelihood of longer LOS (Q3: odd ratio/OR = 1.32, 95% confidence interval/CI = 1.06-1.64; Q4: OR = 1.33, 95% CI = 1.07-1.65; Q5: OR = 1.55, 95% CI = 1.26-1.91). As for DWMHs, moderate DWMHs were related to longer LOS (Q4: OR = 1.33, 95% CI = 1.03-1.71; Q5: OR = 1.63, 95% CI = 1.26-2.11). Finally, severity of overall WMHs was independently associated with LOS, which was similar to the results of DWMHs.
  
  
  CONCLUSIONS
  These findings would advocate for prevention of WMHs to stave off excess medical resource utilization in patients with cognitive impairment.
authors: Department of Psychiatry, Ajou University School of Medicine, Suwon, Republic of Korea.
authors: Ki Jung
authors: KJ
authors: Chang
authors: Department of Medicare Administration, Backseok Arts University, Seoul, Republic Korea.
authors: Soojin
authors: S
authors: Lee
authors: Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Republic of Korea.|Institute on Aging, Ajou University Medical Center, Suwon, Republic of Korea.
authors: Yunhwan
authors: Y
authors: Lee
authors: Department of Psychiatry, CHA University School of Medicine, CHA Hospital, Gangnam, Republic of Korea.
authors: Kang Soo
authors: KS
authors: Lee
authors: Health Insurance Policy Research Institute, National Health Insurance Service, Seoul, Republic of Korea.
authors: Joung Hwan
authors: JH
authors: Back
authors: Department of Psychiatry, Ajou University School of Medicine, Suwon, Republic of Korea.
authors: Young Ki
authors: YK
authors: Jung
authors: Department of Psychiatry, Ajou University School of Medicine, Suwon, Republic of Korea.
authors: Ki Young
authors: KY
authors: Lim
authors: Department of Psychiatry, Ajou University School of Medicine, Suwon, Republic of Korea.
authors: Jai Sung
authors: JS
authors: Noh
authors: Department of Psychiatry, National Medical Center, Seoul, Republic of Korea.
authors: Hyun Chung
authors: HC
authors: Kim
authors: Department of Psychiatry, Ajou University School of Medicine, Suwon, Republic of Korea.
authors: Hyun Woong
authors: HW
authors: Roh
authors: Department of Neurology, Inha University College of Medicine, Incheon, Republic of Korea.
authors: Seong Hye
authors: SH
authors: Choi
authors: Department of Psychiatry, Asan Medical Center, Seoul, Republic of Korea.
authors: Seong Yoon
authors: SY
authors: Kim
authors: Department of Psychiatry, Ajou University School of Medicine, Suwon, Republic of Korea.
authors: Sang
authors: S
authors: Joon Son
authors: Department of Psychiatry, Ajou University School of Medicine, Suwon, Republic of Korea.|Institute on Aging, Ajou University Medical Center, Suwon, Republic of Korea.|Memory impairment center, Ajou University Hospital, Suwon, Republic of Korea.
authors: Chang Hyung
authors: CH
authors: Hong
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000473:pathology* / Q000628:therapy; D005260:Female; D006801:Humans; D007902:Length of Stay; D016015:Logistic Models; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D066127:White Matter / Q000473:pathology*
keywords: Cognitive impairment; dementia; length of hospital stay; white matter hyperintensities