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Table 2 Clinical factors associated with medical care visits

From: Clinical factors associated with recent medical care visits in nursing homes: a multi-site cross-sectional study

Variable

Unadjusted Analysis

Adjusted

Analysis

OR (95% CI)

aOR (95% CI)

Demographics

Age (Years)

1.00 (0.99 – 1.01)

-

Sex (Female)

0.87 (0.73 – 1.03)

-

Cognition, mood, behaviour

Diagnosis

  Alzheimer’s disease

  Dementia other than Alzheimer’s disease b

  Anxiety disorder or depression

0.90 (0.72 – 1.12)

1.09 (0.92 – 1.29)

1.06 (0.87 – 1.28)

-

-

-

Moderately or severely impaired cognitive skills for daily decision-making c

1.09 (0.92 – 1.28)

-

Deteriorated cognitive status d

1.50 (1.00 – 2.26)

-

Wandering behaviours exhibitede

1.23 (1.02 – 1.48) a

1.34 (1.09 – 1.63) a

Presence of ≥ 1 indicators of delirium c

0.94 (0.78 – 1.13)

-

Parenteral/IV or feeding tubec

5.04 (1.58 – 16.1) a

-

Mood

   ≥ 1 indicators of depression, sadness, or anxiety c

  Deteriorated mood d

1.21 (1.02 – 1.43) a

1.16 (0.83 – 1.62)

-

-

Falls, mobility, pressure ulcers

Fall occurred in last 180 days

1.25 (1.05 – 1.47) a

-

Fractures

  Hip fracture occurred in last 180 days

  Other fracture occurred in last 180 days

2.68 (1.16 – 6.21) a

1.03 (0.57 – 1.85)

2.19 (0.93 – 5.12)

-

Presence of ≥ 1 ulcers (Any stage) c

1.36 (1.07 – 1.74) a

1.37 (1.05 – 1.78) a

Hypotension

1.01 (0.48 – 2.12)

-

Pain management

Frequency (Daily or less than daily) c f

1.33 (1.12 – 1.60) a

-

Intensity (Moderate, horrible, or excruciating) c f

0.81 (0.65 – 1.02)

-

Urinary

Incontinence

 Bladder g h

 Bowel g h

 Deteriorated urinary continenced

1.19 (0.99 – 1.43)

1.22 (1.03 – 1.44) a

0.89 (0.64 – 1.23)

-

-

-

Urinary tract infection§§

1.66 (1.18 – 2.34) a

1.52 (1.06 – 2.18) a

Ostomy present g

0.73 (0.39 – 1.37)

-

Urinary catheter present (External, indwelling, or intermittent) g

1.86 (1.11 – 3.11) a

-

Clinical symptoms

Stability of conditions

  Acute episode or flare-up of recurrent or chronic problem c

  End-stage disease e ||

1.48 (1.05 – 2.09) a

11.13 (1.53 – 80.91)a

-

9.70 (1.32 – 71.02) a

Chronic diseases

  Diabetes mellitus

  Congestive heart failure

  Hypertension

  Stroke

  COPD

  Cancer

0.92 (0.76 – 1.12)

1.22 (0.92 – 1.64)

0.99 (0.83 – 1.20)

1.10 (0.89 – 1.35)

0.92 (0.71 – 1.18)

0.97 (0.75 – 1.26)

-

-

-

-

-

-

Weight gain or loss of ≥ 1.5 kg (3 lbs.) c

4.66 (0.62 – 34.85)

-

Shortness of breath c

1.47 (1.03 – 2.10) a

-

Medications

New medications initiated d

1.42 (1.18–1.69) a

1.31 (1.09 – 1.57) a

Number of medications c

1.02 (1.00 – 1.04)

-

Received the following medications for ≥ 1 days c

  Psychoactive medication (Antipsychotic, antianxiety, antidepressant, or hypnotic)

  Diuretic

  Analgesic

1.03 (0.86 – 1.23)

1.18 (0.97 – 1.42)

1.36 (1.15 – 1.60) a

-

-

1.24 (1.03 – 1.49) a

Special treatments and procedures

Past hospital use d

   ≥ 1 admissions with an overnight stay

   ≥ 1 ED visits

1.56 (1.26 – 1.93) a

1.61 (1.30 – 1.99) a

-

-

  1. OR Odds Ratio, aOR Adjusted Odds Ratio, CI Confidence Interval, IV Intravenous Therapy, COPD Chronic Obstructive Pulmonary Disease, ED Emergency Department
  2. a Significant at the level of .05
  3. b Includes diagnoses of organic brain syndrome or chronic brain syndrome, senility, senile dementia, multi-infarct dementia, and dementia related to neurologic diseases other than Alzheimer’s (e.g., Picks, Creutzfeld-Jacob, Huntington’s disease, etc.)
  4. c Observation period: last 7 days
  5. d Observation period: last 90 days
  6. e Behaviour exhibited at any frequency in the last 7 days (e.g., 1 to 3 days, 4 to 6 days, or daily)
  7. f Any type of physical pain or discomfort in any part of the body. Pain may be localized to one area, or may be more generalized. It may be acute or chronic, continuous, or intermittent, or occur at rest or with movement
  8. g Observation period: last 14 days
  9. h Incontinent episodes occurring once a week or less (bladder) or less than weekly (bowel), occasionally incontinent, frequently incontinent, or having inadequate control
  10. §§ Observation period: last 30 days
  11. || Six months or less to live