Influence of comorbidities, geriatric syndromes, and frailty on mortality risk by discharge destination in older adults after acute hospitalization
A nationwide cohort study
Bibliographic Data
| ID | 22069299 |
|---|---|
| Authors | Sunyoung Kim (0000-0002-7376-164X, Kyung Hee University Medical Center), Jae-ryun Lee (0000-0001-6776-3406, Seoul National University Bundang Hospital), Kyeongeun Kim (Kyung Hee University Medical Center), Jungha Park (0000-0002-9559-3018, Kyung Hee University Medical Center), Keehyuck Lee (0000-0001-6906-4887, Seoul National University), Hye Yeon Koo (0000-0002-0387-4278, Seoul National University), Eunbyul Cho (0000-0003-3431-1109, Sacred Heart Hospital), Hyejin Lee (0000-0002-2876-8391, Seoul National University, corresponding author) |
| Year | 2026 |
| Volume | 14 |
| Pages | 1754972-1754972 |
| Publication date | 2026-02-27 |
| Peer Reviewed | Yes |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | Frontiers in Public Health (JOURNAL) |
| Journal identifiers | ISSN: 2296-2565 • E-ISSN: 2296-2565 |
| Publisher | Frontiers Media SA (PUBLISHER • CH) |
| DOI | 10.3389/fpubh.2026.1754972 |
| PMID | 41835403 |
| OpenAlex | W7131828570 |
| Language | EN |
| References cited | 34 |
Background: This study investigated its impact of discharge destination on mortality risk among older adults following acute hospital discharge, focusing on the effects of frailty, geriatric syndromes, and comorbidities. Methods: Nationwide claims data from the South Korean National Health Insurance Service of individuals aged ≥65 years who were discharged from acute care hospitals in 2017 were retrospectively analyzed, with participants followed for mortality outcomes over 4 years. Multivariable Cox proportional hazards models were used to estimate adjusted hazard ratios (aHR) for mortality according to discharge destination and geriatric status. Results: This study included 1,115,556 participants (mean age, 75.5 years; 45.6% men). The most common discharge destination was home (76.5%), followed by tertiary/general hospitals (15.2%), long-term care hospitals (5.2%), hospitals (2.3%), and other facilities (0.8%). Patients discharged to long-term care hospitals were older, had a higher comorbidity burden, and more frequently had disabilities or geriatric syndromes than their counterparts. Mortality risk was significantly higher among those discharged to tertiary/general hospitals (aHR 1.806, 95% CI: 1.793-1.820), general hospitals (aHR 1.480, 95% CI: 1.453-1.507), and long-term care hospitals (aHR 2.922, 95% CI: 2.892-2.952) than among those discharged to home. Higher Charlson comorbidity index (≥3), more geriatric syndromes, and severe frailty were all independently associated with increased mortality risk. Conclusion: Discharge destination, frailty, geriatric syndromes, and comorbidities independently and interactively influenced the mortality risk in older adults after acute hospitalization. Tailored post-discharge management strategies are necessary, particularly for patients with frailty and multimorbidity in community settings
Acute care · Charlson comorbidity index · Cohort study · Comorbidity · Geriatric care · Geriatrics · Hazard ratio · Multimorbidity · Proportional hazards model · Emergency and Acute Care Studies · Frailty in Older Adults · Heart Failure Treatment and Management
| Citation velocity | historical |
|---|---|
| Highly cited | No |