Hospital Readmission ,Malnutrition and Associated Factors among Elderly Hospitalized Patients in Internal Medicine Wards, Menoufia University Hospitals

Objectives: to identify reasons for re-hospitalization, assess nutritional status of elderly hospitalized patients using a validated nutritional assessment tool and analyze which factors are associated with readmission within the last year after discharge from index hospitalization for elderly hospitalized patients including nutritional related factors. Methodology: A cross-sectional study design was conducted in the internal medicine wards of Menoufia university hospital. All patients over 65 years of age within the first 72 hours of admission were eligible for the study. 162 patients were recruited with (93.6%) response rate. Data being collected using a structured questionnaire includes patients' sociodemographic, admission characteristics, severity of chronic disease using Cumulative Illness Rating Scale (CIRS) for geriatric. Assessment of nutrition status was performed using Mini Nutritional Assessment (MNA) tool and anthropometric measurements. Results: readmission within one year was found among (46.3%) of elderly participants. Relapse of initial condition was the most common reason (42.7%) followed by complications (24%). Half of readmitted group was malnourished and nearly one third at risk of malnutrition. Logistic regression identified strong association of hospital readmission with advanced old age ,smoking habit , poor dietary compliance , assistance needed feeding pattern ,severity of chronic disease ,comorbidities and lower MNA score Conclusion : Factors associated with readmission in elderly patients are multiple and complex. Malnourished elderly patients with cardiac , respiratory disease or diabetic with complex medical and social needs who are severely ill , with advanced age, smoker , who not compel well with dietary advice ,need assistance with feeding are tend to be readmitted. Recommendations: Re-hospitalized elderly patients should be identified and targeted by follow up and post hospital care to reduce readmissions.