ArticleBMJ open2019
Changes in vulnerability among older patients with cardiovascular disease in the first 90 days after hospital discharge: A secondary analysis of a cohort study.
Article in BMJ open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- Utility of the Vulnerable Elders Survey-13 (VES-13) in detecting frailty and predicting prognosis in heart failure outpatients.Journal of geriatric cardiology : JGC · 2026Article
- Physical Resilience After Hip Fracture: Unpacking the Roles of Resistance and Recovery.Journal of the American Geriatrics Society · 2025Article
- An Overview of Instruments to Assess Vulnerability in Healthcare: A Scoping Review.Healthcare (Basel, Switzerland) · 2025Review
- Cardiometabolic Disorders Are Important Correlates of Vulnerability in Hospitalized Older Adults.Nutrients · 2023Article
- Article
- Hospital to Home: Supporting the Transition From Hospital to Home for Older Adults.The Canadian journal of nursing research = Revue canadienne de recherche en sciences infirmieres · 2022Article
- Medications Associated With Geriatric Syndromes (MAGS) and Hospitalization Risk in Home Health Care Patients.Journal of the American Medical Directors Association · 2022Article
- Post-acute care transitions and outcomes among medicare beneficiaries in assisted living communities.Journal of the American Geriatrics Society · 2022Article
- Utilization and Functional Outcomes Among Medicare Home Health Recipients Varied Across Living Situations.Journal of the American Geriatrics Society · 2021Article
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
objectives(1) To compare changes in vulnerability after hospital discharge among older patients with cardiovascular disease who were discharged home with self-care versus a home healthcare (HHC) referral and (2) to examine factors associated with changes in vulnerability in this period.
designSecondary analysis of longitudinal data from a cohort study. PARTICIPANTS AND
setting834 older (≥65 years) patients hospitalised for acute coronary syndromes and/or acute decompensated heart failure who were discharged home with self-care (n=713) or an HHC referral (n=121). OUTCOME: Vulnerability was measured using Vulnerable Elders Survey 13 (VES-13) at baseline (prior to hospital admission) and 30 days and/or 90 days after hospital discharge. Effects of HHC referral on postdischarge change in vulnerability were examined using three linear regression approaches, with potential confounding on HHC referral adjusted by propensity score matching.
resultsOverall, 44.4% of the participants were vulnerable at prehospitalisation baseline and 34.4% were vulnerable at 90 days after hospital discharge. Compared with self-care patients, HHC-referred patients were more vulnerable at baseline (66.9% vs 40.3%), had more increase (worsening) in VES-13 score change (B=-1.34(-2.07, -0.61), p<0.001) in the initial 30 days and more decrease (improvement) in VES-13 score change (B=0.83(0.20, 1.45), p=0.01) from 30 to 90 days after hospital discharge. Baseline vulnerability and the HHC referral attributed to 14%-16% of the variance in vulnerability change during the 90 postdischarge days, and 6% was attributed by patient age, race (African-American), depressive symptoms, and outpatient visits and hospitalisations in the past year.
conclusionAfter adjusting for preceding vulnerability and covariates, older hospitalised patients with cardiovascular disease referred to HHC had delayed recovery in vulnerability in first initial 30 days after hospital discharge and greater improvement in vulnerability from 30 to 90 days after hospital discharge. HHC seemed to facilitate improvement in vulnerability among older patients with cardiovascular disease from 30 to 90 days after hospital discharge.
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