Better health-related quality of life (mental component summary), having a higher level of education, and being less than 75 years of age are predictors of hospital admission among cognitively intact nursing home residents: a 5-year follow-up study

Figures & data

Table 1 Descriptive statistics for ADL, HADS-A, HADS-D, SF-36 PCS, and MCS for 227 cognitively intact NH residents with and without cancer diagnosis in Bergen, Norway, in 2004–2005 with 5 years of follow-up

Scale	Cancer (n =60)			No cancer (n =167)			P-value (t-test)
	Mean	SD	Range	Mean	SD	Range
ADL	1.95	0.48	1–3	1.99	0.47	1–3	0.55
HADS-A	3.9	3.8	0–16	4.1	3.8	0–17	0.49
HADS-D	6.0	4.2	0–18	5.9	4.2	0–16	0.82
SF-36 PCS	31.7	8.0	14.9–46.5	34.0	9.8	9.4–61.2	0.10
SF-36 MCS	51.4	11.3	22.4–69.3	51.9	10.8	10.2–71.1	0.75

Abbreviations: ADL, activities of daily living mean score; HADS-A, Hospital Anxiety and Depression Scale sum score – anxiety; HADS-D, Hospital Anxiety and Depression Scale sum score – depression; SF-36, Short Form-36 Health Survey; PCS, physical component summary; MCS, mental component summary; SD, standard deviation; NH, nursing home.

Table 2 Descriptive statistics for hospital days according to diagnosis groups for 81 cognitively intact nursing home residents admitted to hospital according to diagnosis at discharge and with and without cancer diagnosis at inclusion in Bergen, Norway, 2004–2005 with 5 years of follow-up

Diagnosis at hospital discharge (ICD-10 codes, main chapter)	Hospital stay in days according to diagnosis group
	Residents with cancer					Residents without cancer
	n	(%)	Median	(Q1, Q3)	Range	n	(%)	Median	(Q1, Q3)	Range
Infectious diseases
(A00–B99)	1	(3.8)	1.0	na	na	4	(7.3)	4.5	(1.7, 15.5)	1–19
Cancer
(C00–D48)	8	(30.8)	0.0	(0.0, 11.3)	0–16	2	(3.6)	2.0	na	0–4
Diseases of the blood and blood-forming organs
(D50–89)	1	(3.8)	na	na	na	1	(1.8)	4.5	na	na
Mental disorders
(F00–99)	1	(3.8)	0.0	na	na	0	(0.0)	na	na	na
Diseases of the circulatory system
(I00–99)	5	(19.2)	3.0	(1.0, 4.5)	0–5	13	(23.6)	1.0	(0.0, 2.5)	0–11
Diseases of the respiratory system
(J00–99)	3	(11.5)	4.0	na	3–7	13	(23.6)	5.0	(1.0, 8.0)	0–13
Diseases of the digestive system
(K00–99)	1	(3.8)	0.0	na	na	4	(7.3)	0.5	(0.0, 5.5)	0–7
Diseases of the genitourinary system
(N00–N99)	4	(15.4)	0.0	(0.0, 0.5)	0–1	5	(9.1)	0.0	(0.0, 3.0)	0–3
Other and not specified diagnoses
(L00–99, M00–99, R00–99, S00–99, Z00–99)	2	(7.7)	1.0	(0.0, 2.0)	0–2	13	(23.6)	0.0	(0.0, 0.5)	0–13
Total admissions	26	(100.0)	0.5	(0.0, 4.0)	0–16	55	(100.0)	1.0	(0.0, 5.0)	0–19

Abbreviations: ICD-10, International Classification of Diseases, 10th revision; na, not applicable; Q1, lower quartile; Q3, upper quartile.

Table 3 Results from proportional hazard regression analysis of time to first hospital admission for 227 cognitively intact NH residents in Bergen, Norway, in 2004–2005 with 5 years of follow-up

Patient characteristics at inclusion	Unadjusted			Fully adjusted (n =227)			Final model (n =227)a
	Hazard ratio	95% CI	Likelihood ratio test (P-value)	Hazard ratio	95% CI	Likelihood ratio test (P-value)	Hazard ratio	95% CI	Likelihood ratio test (P-value)
Sex			0.27			0.56
Women	1			1	Reference
Men	1.27	(0.80, 2.04)		1.16	(0.65, 2.03)
Age group (years)			0.14			0.05			0.04
65–74	1			1	Reference		1
75–84	0.82	(0.41, 1.63)		0.56	(0.25, 1.23)		0.59	(0.28, 1.23)
85–94	0.91	(0.46, 1.79)		0.69	(0.30, 1.58)		0.72	(0.35, 1.49)
≥95	0.34	(0.10, 1.03)		0.23	(0.06, 0.81)		0.23	(0.07, 0.75)
Educational level			0.11			0.02			0.02
Primary school	1			1	Reference		1
<3 years after primary school	0.93	(0.58, 1.50)		0.71	(0.42, 1.19)		0.73	(0.44, 1.19)
≥3 years after primary school	1.91	(1.01, 3.62)		1.96	(0.99, 3.88)		1.95	(1.00, 3.77)
Marital status			0.77			0.96
Married or cohabiting	1			1	Reference
Divorced	0.81	(0.38, 1.71)		0.91	(0.38, 2.17)
Unmarried	0.98	(0.36, 2.69)		0.75	(0.25, 2.30)
Widowed	0.98	(0.13, 1.32)		0.91	(0.45, 1.81)
Groll’s FCI	1.07	(0.90, 1.28)	0.48	1.09	(0.91, 1.32)	0.35
ADL mean	0.83	(0.52, 1.30)	0.41	0.93	(0.54, 1.60)	0.89
HADS-A	0.99	(0.93, 1.05)	0.67	1.01	(0.93, 1.09)	0.59
HADS-D	0.92	(0.92, 1.03)	0.33	1.00	(0.94, 1.07)	0.48
SF-36
MCS per 10 points	1.22	(0.98, 1.52)	0.07	1.27	(0.96, 1.66)	0.03	1.27	(1.02, 1.59)	0.03
PCS per 10 points	1.01	(0.89, 1.39)	0.40	1.06	(0.80, 1.42)	0.67
Cancer diagnosis	1.69	(1.33, 2.64)	0.03	1.87	(1.10, 3.18)	0.02	1.93	(1.19, 3.14)	0.01

Notes:

a From backward stepwise selection from the full model with nominal P≤0.05. The SF-36 Health Survey also allows for constructing scores that summarize physical (PCS) and mental (MCS) components of quality of life across the eight subscales. The ranges for the subscores are 0–100 for MCS and 0–100 for PCS (the higher the score, the better the state of health). Functional Comorbidity Index (FCI): number of diagnoses, scale from 0 to 18 (maximum observed 6).

Abbreviations: CI, confidence interval; FCI, Functional Comorbidity Index: number of diagnoses, scale from 0 to 18 (maximum observed 6); ADL, activities of daily living; HADS-A, Hospital Anxiety and Depression Scale – anxiety; HADS-D, Hospital Anxiety and Depression Scale – depression; SF-36, Short Form-36 Health Survey; NH, nursing home; PCS, physical component summary; MCS, mental component summary.