Older Patients Vulnerable to “Post-Hospital Syndrome”

The phrase “post-hospital syndrome” was coined by cardiologist Harlan Krumholz, MD, in a New England Journal of Medicine article in 2013, when he noticed that most 30-day readmissions among patients >65 years old could be attributed to conditions seemingly unrelated to a patient’s initial diagnosis.

For example, patients who were admitted with heart failure or pneumonia were often readmitted with internal bleeding or injuries from a fall.

Now, researchers and clinicians are becoming more aware of the lingering effects of a stressful hospitalization and are looking for solutions to preventing and minimizing post-hospital syndrome, according to a report in The New York Times.

“Our general approach in a hospital is all hands on deck to deal with the problem people come in with,” Dr. Krumholz told The New York Times. “All the other discomforts are seen as a minor inconvenience.” Instead, he wants clinicians to view discharge as the beginning of a two- to three-month period when patients are particularly vulnerable to a variety of other health problems.

The stresses of a hospitalization, including disrupted sleep, unappetizing or irregular meals, poor balance due to extended time in a bed, and new prescriptions with unfamiliar side effects – contribute to this period of increased vulnerability.

Solutions to this problem will likely require a cultural change, Dr. Krumholz noted. To make hospitals more conducive to healing for older patients, he proposed adopting new policies that are less destabilizing for patients. For example, allowing patients to wear their own clothes, limiting the number of lab tests performed, and creating less-stressful environments, like specialized geriatric emergency rooms.

Source: The New York Times, August 3, 2018.