Hospital stays may be placing some patients at risk for further injury and hospital readmission, according to new research. The more traumatic the stay, it seems, the greater the likelihood of new health problems.
The issue seems to be significant among the elderly, where a hospital stay might lead to new health issues that cause the patient to become sick enough that another admission might be needed within a matter of days or weeks of the original discharge, said USA Today, citing the research. Some one in every five hospitalized Medicare patients are readmitted within 30 days of their original admission.
For the most part, the readmissions are not over prior illness flare up, but due to a new problem, often caused by the trauma of hospitalization, suggests a new study, said USA Today. For example, patients hospitalized for pneumonia might become weakened after the hospital stay and then fall and break a bone, according to renowned cardiologist and professor at Yale School of Medicine, Harlan Krumholz. Krumholz has authored two papers on the subject, noted USA Today.
“They come into the hospital with one thing, but they leave with another,” Krumholz said. His study of Medicare patients appears in the most current Journal of the American Medical Association. “Maybe what is going on is that people, through the hospitalization, are acquiring a new condition, something that makes them susceptible to a whole range of problems,” Krumholz added. Krumholz also discussed “post-hospital” syndrome—a phrase he coined—in a New England Journal of Medicine paper, also this month.
Post-hospital syndrome, explained USA Today is a temporary period in which a patient is at increased vulnerability to a wide array of risks that include injuries ranging from falls to heart attack, among other injuries.
A recent headline-making example of this was seen with former Secretary of State Hillary Clinton. The matter appeared to have snowballed from a relatively minor illness, noted USA Today. Clinton suffered from a gastrointestinal illness, which caused dehydration and weakness, which led to her fall. Clinton hit her head and suffered a concussion from that fall and her head trauma led to a blood clot in her head, which necessitated hospitalization.
According to the study, of patients who are readmitted, 90 percent were first diagnosed with a heart attack, but came back with a different problem, as did 65 percent of heart failure patients and 78 percent of pneumonia patients. The study reviewed more than three million hospitalizations and was based on Medicare records, said USA Today.
The problem is not poor care or mistakes but, rather, the issue of being a patient, said Krumholz. Consider that patients do not necessarily sleep their best in noisy, brightly lit hospital units and may experience sleep interruptions with nurses checking vital signs or administering medication. Patients may not be eating sufficiently, especially if their physicians ordered a fast prior to a procedure, USA Today pointed out. Also, patients may be prescribed medications that cause drowsiness or confusion, even delirium; a problem when patients are in unfamiliar surroundings. Also, said Krumholz, long periods of bed rest weakens muscles and bones.
“When you go through what most people go through in a hospitalization, you are impaired,” Krumholz said. Even “if you took a healthy person through this, they would still be in a period of susceptibility” to health problems.
Physician Peter Pronovost, Johns Hopkins’ senior vice president for patient safety and quality also pointed out that patients in good mental health may become psychotic in the hospital due to the collaborative effects of sleep deprivation, medications, and stress, wrote USA Today. “Many ICU patients will say, ‘I thought the nurses were trying to kill me,'” Pronovost said. These patients are not in the best condition to understand discharge instructions and may be at risk for increased deterioration, he said.
