Care home residents admitted to hospital through the emergency pathway: characteristics and associations with inpatient mortality

Background Routinely collected hospital information could help to understand the characteristics and outcomes of care home residents admitted to hospital as an emergency.

Methods This retrospective 2-year service evaluation included first emergency admissions of any older adult (≥75 years) presenting to Cambridge University Hospital. Routinely collected patient variables were captured by an electronic patient record system. Care home status was established using an official register of care homes.

Results 7.7% of 14,777 admissions were care home residents. They were older, frailer, more likely to be women and have cognitive impairment than those admitted from their own homes. Additionally, 42% presented with an Emergency Department Modified Early Warning Score above the threshold triggering urgent review, compared to 26% of older adults from their own homes. Admission from a care home was associated with higher 30-day inpatient mortality (11.1 vs 5.7%), which persisted after multivariable adjustment (hazard ratio: 1.42; 95% confidence interval: 1.09–1.83; p = 0.008).

Conclusion Care home residents admitted to hospital as an emergency have high illness acuity and inpatient mortality.