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Cited by 21Dementia and Cognitive Impairment ResearchPalliative Care and End-of-Life IssuesGeriatric Care and Nursing Homes

Risk factors for in-hospital mortality in patients with dementia

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Golüke, Nienke M.S., van de Vorst, Irene E., Vaartjes, Ilonca H., Geerlings, Mirjam I., de Jonghe, Annemarieke, Bots, Michiel L., Koek, Huiberdina L.·2019·Maturitas
DOI 10.1016/j.maturitas.2019.08.007
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Abstract

Objective To examine the in-hospital mortality rate, and its risk factors, for patients with dementia admitted to hospital.Study design We constructed an observational cohort study through data linkage of three Dutch national registers: the hospital discharge register (HDR), the population register (PR) and the national cause of death register. Patients with dementia in the HDR aged between 60 and 100 years registered between 1 January 2000 and 31 December 2010 were included.Main outcome measures Risk factors for in-hospital mortality were investigated using multivariable Cox proportional hazard regression models that included sex, age, marital status, ethnicity, somatic comorbidity, type of dementia and urgency of admission.Results 40,500 patients were included in the cohort. The overall in-hospital mortality rate was 11.1%. Factors that significantly increased the mortality risk were: male sex (adjusted hazard ratio (HR) 1.52, 95%-confidence interval (95%-CI) 1.43-1.63), higher age (adjusted HR 1.03, 95%-CI 1.03-1.04), living with a partner (adjusted HR 1.39, 95%-CI 1.30-1.49), acute admission (adjusted HR 2.16, 95%-CI 1.97-2.36) and Alzheimer's disease (adjusted HR 1.21, 95%-CI 1.13-1.29). Cardiovascular disease was the most common cause of in-hospital mortality.Conclusions This nationwide study found several independent risk factors for the in-hospital mortality of patients with dementia, including male sex, higher age, living with a partner, acute admission, and Alzheimer's disease. These risk factors should be taken into account by clinicians and caregivers as they will indicate whether patients are at risk of a more unfavourable outcome during hospital admission.

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  • Hospital admission can trigger distress, confusion, and delirium and lead to worse outcomes in patients with dementia or other neurological issues.

    “For example, hospital admission can trigger distress, confusion, and delirium and lead to worse outcomes in patients with dementia or other neurological issues.73,74”

    From Joint Clinical Practice Guideline on Benzodiazepine Tapering: Considerations When Risks Outweigh Benefits (2025) · cites this paper as [74]

  • A higher risk of mortality (positive SHAP value) was predicted by old age (NACCAGE), male sex (SEX), higher levels of dependency (INDEPEND), higher levels of personal care required (PERSCARE), greater difficulty in handling a stove or heating water (STOVE), more years of education (EDUC), and more seconds required to complete the Trail Making Test Part B (TRAILB) across all four survival-time.

    “Notably, a higher risk of mortality (positive SHAP value) was predicted by old age (“NACCAGE”), male sex (“SEX”), higher levels of dependency (“INDEPEND”), higher levels of personal care required (“PERSCARE”), greater difficulty in handling a stove or heating water (“STOVE”), more years of education (“EDUC”), and more seconds required to complete the Trail Making Test Part B (“TRAILB”) across all”

    From Machine learning models identify predictive features of patient mortality across dementia types (2024) · cites this paper as [53]

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Authors
Golüke, N. M. S., van de Vorst, I. E., Vaartjes, I. H., Geerlings, M. I., de Jonghe, A., Bots, M. L., & Koek, H. L.
Affiliations
  • University Medical Center Utrecht (NL)
  • Utrecht University (NL)
Corresponding author
Golüke, Nienke M.S.
ORCID
Venue
Maturitas
Publisher
Elsevier BV
Published
2019-11
Volume
129
Pages
57-61
ISSN
0378-5122 (ISSN-L)
DOI
10.1016/j.maturitas.2019.08.007
OpenAlex
W2969984476
Cited by
21
References
19
Citations by year
2026: 2 · 2025: 6 · 2024: 4 · 2023: 2 · 2022: 1 · 2021: 4 · 2020: 1 · 2012: 1
FWCI
1.19
Type
journal article
Language
en
Open access
Licence
Locations
  • Maturitas (publishedVersion)
  • PubMed (publishedVersion)
  • Utrecht University Repository (Utrecht University) (submittedVersion, other-oa)
  • Pure Amsterdam UMC (submittedVersion)
Funders
  • Hartstichting
  • Alzheimer Nederland
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
  • Health Sciences › Health Professions › General Health Professions › Geriatric Care and Nursing Homes
Keywords
dementia, in-hospital mortality, risk factors, Alzheimer's disease, acute hospitalization, sex differences, marital status, age, cardiovascular disease, somatic comorbidity, older adults
MeSH terms
Age Factors, Aged, Aged, 80 and over, Alzheimer Disease, Cardiovascular Diseases, Dementia, Female, Humans, Male, Medical Record Linkage, Middle Aged, Netherlands, Registries, Risk Factors, Sex Factors, Cohort Studies, Comorbidity, Proportional Hazards Models, Hospital Mortality

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