Permanent cognitive or physical impairment after transfer from long-term care to acute care: a retrospective cohort study.
Background Long-term care (LTC) residents are frequently transferred to emergency departments (ED), which may increase the risk of impairment. Objective To examine associations between all-cause ED transfers and development of new permanent severe physical and cognitive impairments, and death. Setti...
| Publicado en: | Age & Ageing Vol. 55; no. 4; pp. 1 - 10 |
|---|---|
| Autores principales: | , , , , , , , , , |
| Formato: | Artículo |
| Publicado: |
Oxford University Press / USA
Apr2026
|
| Materias: | |
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ssf&AN=193500071&site=ehost-live header: @attributes: shortDbName: ssf uiTerm: 193500071 longDbName: Social Sciences Full Text (H.W. Wilson) uiTag: AN controlInfo: bkinfo: jinfo: jid: 00020729 AGA jtl: Age & Ageing issn: 00020729 maglogo: N pubinfo: dt: Apr2026 vid: 55 iid: 4 pid: 622 pub: Oxford University Press / USA artinfo: ui: 193500071 10.1093/ageing/afag066 ppf: 1 ppct: 9 formats: tig: atl: Permanent cognitive or physical impairment after transfer from long-term care to acute care: a retrospective cohort study. aug: au: Yin, Christina Scott, Mary Talarico, Robert Hakimjavadi, Ramtin Kierulf, Jackie Webber, Colleen Hawken, Steven Moledina, Aliza Manuel, Douglas G Hsu, Amy T affil: Ottawa Hospital Research Institute Clinical Epidemiology Program, Ottawa, Ontario, Canada Ottawa Hospital Research Institute Clinical Epidemiology Program, Ottawa, Ontario, CanadaPublic Health Agency of Canada, Ottawa, Ontario, Canada Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada University of Ottawa Faculty of Medicine, Ottawa, Ontario, Canada Bruyère Research Institute, 43 Bruyère Street, Ottawa, Ontario K1N 5C8, Canada Institute for Clinical Evaluative Sciences, Toronto, Ontario, CanadaOttawa Hospital Research Institute Ottawa Methods Centre, Ottawa, Ontario, Canada Ottawa Hospital Research Institute Clinical Epidemiology Program, Ottawa, Ontario, CanadaUniversity of Ottawa Faculty of Medicine, Ottawa, Ontario, Canada Ottawa Hospital Research Institute, Ottawa, Ontario, CanadaUniversity of Ottawa, Department of Family Medicine, Ottawa, Ontario, Canada su: Canada Ontario Retrospective studies Quality of life Critical care medicine People with disabilities Old age Research funding Acute diseases Long-term health care Frail elderly Hospital emergency services Descriptive statistics Longitudinal method Cognition disorders Medical records Acquisition of data Geriatric assessment Confidence intervals Data analysis software Transportation of patients Proportional hazards models Comorbidity sug: subj: Retrospective studies Quality of life Critical care medicine People with disabilities Old age Canada Ontario Research funding Acute diseases Long-term health care Frail elderly Hospital emergency services Descriptive statistics Longitudinal method Cognition disorders Medical records Acquisition of data Geriatric assessment Confidence intervals Data analysis software Transportation of patients Proportional hazards models Comorbidity keyword: cognitive impairment copyrightHolder:British Geriatrics Society copyrightYear:2026 https://dx.doi.org/10.1093/ageing/afag066 impairment inLanguage:en internship and residency long-term care medical residencies mortality older people publisher:Oxford University Press sameAs:https://pubmed.ncbi.nlm.nih.gov/41947567/ transfer transfer technique cognitive impairment copyrightHolder:British Geriatrics Society copyrightYear:2026 https://dx.doi.org/10.1093/ageing/afag066 impairment inLanguage:en internship and residency long-term care medical residencies mortality older people publisher:Oxford University Press sameAs:https://pubmed.ncbi.nlm.nih.gov/41947567/ transfer transfer technique ab: Background Long-term care (LTC) residents are frequently transferred to emergency departments (ED), which may increase the risk of impairment. Objective To examine associations between all-cause ED transfers and development of new permanent severe physical and cognitive impairments, and death. Setting and Participant Adults ≥65 with incident admission to LTC homes in Ontario, Canada between 2013 and 2018. Methods We conducted a retrospective cohort study. We examined rates of (i) severe physical impairment, (ii) severe cognitive impairment and (iii) all-cause mortality after transfer to ED. We used marginal structural models to estimate the combined effect of acute illness and ED transfer. We used an instrumental variable (IV) analysis to isolate the effect of transfer, adjusting for acute illness. Results Of 120,238 residents, 78,546 (65.3%) residents had at least one transfer to the hospital. The mean (SD) age was 84.6 (7.9) years, 67.2% were female. The incidence rate ratios were 3.0 (95% CI, 2.9–3.1) for new physical impairment, 2.2 (95% CI, 2.1–2.3) for cognitive impairment and 5.8 (95% CI, 5.7–5.9) for mortality, comparing transferred to never-transferred residents. In IV analysis, transfers were not associated with permanent physical or cognitive impairment (hazard ratio [HR] (95% CI) [HR1.20] (0.92–1.55); [HR0.86] (0.69–1.06), but were associated with decreased mortality [HR0.57] (CI 0.50–0.63). Conclusion In unadjusted analyses, residents transferred to ED had a higher incidence of permanent physical impairment, cognitive impairment and mortality. After adjusting for acute illness, transfer decisions were not associated with changes in the risk of severe impairment and were associated with reduced mortality. pubtype: Academic Journal doctype: Article src: R language: English refInfo: copyright: @attributes: flag: N holdings: @attributes: islocal: N |
|---|