Outcomes of dementia: Systematic review and meta-analysis of hospital administrative database studies

• Dementia patients had poorer outcomes compared to older adult patients.
• Meta-analysis showed higher mortality rate associated with dementia patients.
• They had increased mortality, in-hospital complication, and readmission rate.
• They underwent fewer life-saving interventions compared to older adult patients.

IntroductionAim of the study was to compare various outcomes of dementia patients with elderly patients without dementia by conducting a systematic review of previous population-based studies.MethodsThe relevant studies were retrieved from search of electronic databases.ResultsThe pooled data from included 11 studies consisted of outcomes of 1,044,131 dementia patients compared to 9,639,027 elderly patients without dementia. Meta-analysis showed that the mortality in dementia patients was 15.3% as compared to 8.7% in non-dementia cases (RR 1.70, CI 95%, 1.27-2.28, p 0.0004). However, there was significant heterogeneity between the studies (p < 0.00001). Dementia patients had significantly increased overall readmission rate (OR 1.18; 95% CI, 1.08-1.29, p < 0.001). They had higher complication rates for urinary tract infections (RR 2.88; 95% CI, 2.45-3.40, p < 0.0001), pressure ulcers (RR 184; 95% CI, 1.31-1.46, p < 0.0001), pneumonia (RR 1.66; 95% CI, 1.36-2.02, p < 0.0001), delirium (RR 3.10; 95% CI, 2.31-4.15, p < 0.0001), and, dehydration and electrolyte imbalance (RR 1.87; 95% CI, 1.55-2.25, p < 0.0001). Dementia patients had more acute cardiac events (HR 1.16; 95% CI, 1.06-1.28, p 0.002), while fewer revascularization procedures (HR 0.12; 95% CI, 0.08-0.20, p < 0.001). Patients with dementia had lesser use of ITU (reduction by 7.5%; 95% CI, 6.9-8.1), ventilation (reduction by 5.4%; 95% CI, 5.0-5.9), and dialysis (reduction by 0.5%; 95% CI, 0.4-0.8).DiscussionCompared to older adult population, patients with dementia had poorer outcome. Despite higher mortality rate and readmission rate, they underwent fewer interventions and procedures.