Impact of adverse events on hospital disposition in community-dwelling seniors admitted to acute care.

Older adults (> or =65 years) have been identified as a high-risk group for the occurrence of adverse events (AEs) in hospital. The purpose of this paper is to describe the association between AEs and disposition for a population of hospitalized seniors. All community-dwelling seniors admitted to an acute care in-patient unit were eligible for inclusion in this retrospective cohort study conducted at an adult tertiary care facility in Atlantic Canada between July 1, 2005, and March 31, 2006. AEs were identified from administrative data using validated screening criteria derived from the International Classification of Diseases (ICD) diagnosis and external cause of injury codes. Of the 982 eligible patients, 140 (14%) had evidence of at least one AE. There were 136 in-hospital deaths (14%). There was no significant difference in the proportion of deaths between those who experienced an AE and those who did not. However, of the 29 patients who were discharged to a long-term care facility, a significantly higher proportion had an in-hospital AE (6% versus 2%, p < .009). The potential contribution of an AE to the subsequent placement in a long-term care facility offers a compelling reason to develop prevention strategies for hospitalized seniors.