title: Outcomes of dementia: Systematic review and meta-analysis of hospital administrative database studies.
abstract: Aim of the study was to compare various outcomes of dementia patients with elderly patients without dementia by conducting a systematic review of previous population-based studies.
  
  
  
  The relevant studies were retrieved from search of electronic databases.
  
  
  
  The pooled data from included 11 studies consisted of outcomes of 1,044,131 dementia patients compared to 9,639,027 elderly patients without dementia. Meta-analysis showed that the mortality in dementia patients was 15.3% as compared to 8.7% in non-dementia cases (RR 1.70, CI 95%, 1.27-2.28, p 0.0004). However, there was significant heterogeneity between the studies (p<0.00001). Dementia patients had significantly increased overall readmission rate (OR 1.18; 95% CI, 1.08-1.29, p<0.001). They had higher complication rates for urinary tract infections (RR 2.88; 95% CI, 2.45-3.40, p<0.0001), pressure ulcers (RR 184; 95% CI, 1.31-1.46, p<0.0001), pneumonia (RR 1.66; 95% CI, 1.36-2.02, p<0.0001), delirium (RR 3.10; 95% CI, 2.31-4.15, p<0.0001), and, dehydration and electrolyte imbalance (RR 1.87; 95% CI, 1.55-2.25, p<0.0001). Dementia patients had more acute cardiac events (HR 1.16; 95% CI, 1.06-1.28, p 0.002), while fewer revascularization procedures (HR 0.12; 95% CI, 0.08-0.20, p<0.001). Patients with dementia had lesser use of ITU (reduction by 7.5%; 95% CI, 6.9-8.1), ventilation (reduction by 5.4%; 95% CI, 5.0-5.9), and dialysis (reduction by 0.5%; 95% CI, 0.4-0.8).
  
  
  
  Compared to older adult population, patients with dementia had poorer outcome. Despite higher mortality rate and readmission rate, they underwent fewer interventions and procedures.
authors.affiliation: Department of Surgery and Cancer, Faculty of Medicine, Floor 10, QEQM, St Mary's Hospital, Imperial College London, Praed Street, London, W2 1NY, United Kingdom. Electronic address: a.rao@imperial.ac.uk.
authors.forename: Ahsan
authors.initials: A
authors.lastname: Rao
authors.affiliation: Department of Surgery and Cancer, Faculty of Medicine, Floor 10, QEQM, St Mary's Hospital, Imperial College London, Praed Street, London, W2 1NY, United Kingdom.
authors.forename: Amna
authors.initials: A
authors.lastname: Suliman
authors.affiliation: Centre for Health Policy, Institute for Global Health Innovation, Imperial College London, Floor 10, QEQM, St Mary's Hospital, Imperial College London, Praed Street, London, W2 1NY, United Kingdom.
authors.forename: Sabine
authors.initials: S
authors.lastname: Vuik
authors.affiliation: School of Public Health, Faculty of Medicine, Dr. Foster Unit, 3 Dorset Rise, London EC4Y 8EN, United Kingdom.
authors.forename: Paul
authors.initials: P
authors.lastname: Aylin
authors.affiliation: Department of Surgery and Cancer, Faculty of Medicine, Floor 10, QEQM, St Mary's Hospital, Imperial College London, Praed Street, London, W2 1NY, United Kingdom.
authors.forename: Ara
authors.initials: A
authors.lastname: Darzi
mesh_terms: D000368:Aged; D016208:Databases, Factual; D003704:Dementia / Q000401:mortality* / Q000628:therapy; D019468:Disease Management; D014943:Global Health; D017052:Hospital Mortality / Q000639:trends; D006761:Hospitals / Q000706:statistics & numerical data*; D006801:Humans; D010359:Patient Readmission / Q000639:trends; D011379:Prognosis; D015996:Survival Rate / Q000639:trends