Post hospital syndrome refers to the period of heightened risk for patients recently discharged from a hospital. Patients face a recovery period for the acute illness for which they were hospitalized, and face difficulties from the allostatic and physiological stress resulting from a hospital stay.
When discharged, a patient's physiological systems are impaired, reserves are depleted, and often, the body cannot effectively respond to health threats. More than a third of all patients discharged from the hospital require acute care in the next 30 days, and more than 1 in 6 require readmission. Nearly 20% of Medicare patients have an acute medical problem within 30 days of discharge that requires another hospitalization.
To complicate matters, these patients tend to exhibit symptoms that are not related to the original hospitalization. Among patients admitted for treatment of heart failure, pneumonia, or chronic obstructive pulmonary disease (COPD), the cause of readmission is the same as that of the original hospitalization for only 37%, 29%, and 36% of patients, respectively.
What are the Direct Causes of Post Hospital Syndrome?
Post hospital syndrome comes primarily from stresses to normal function and daily rhythm. Hospitalized patients are separated from their usual environments, family, and friends. They experience pain and discomfort, and take medications they are unused to.
It's estimated that 20% to 50% of hospitalized patients are undernourished, and many may suffer from disrupted sleep. In addition, hospitalized patients commonly become deconditioned, experiencing a decrease in stamina, coordination, and strength. This can affect capabilities to resume basic tasks, and increases the risk of falls.
How to Prevent Post-Hospital Syndrome
Treating post hospital syndrome centers around prevention, before the patient is released. When evaluating a patient's fitness to transition from inpatient care, doctors should look beyond the reasons for initial hospitalization. That evaluation process has to include awareness of cognitive and physical functional disabilities, and appropriate care and support.
During hospitalizations, doctors can aim to:
- Reduce disruptions in sleep
- Minimize pain and stress
- Promote good nutrition
- Address nutritional deficiencies
- Optimize the use of sedatives
- Promote practices that reduce the risk of delirium and confusion
- Emphasize physical activity and strength maintenance or improvement
- Enhance cognitive and physical function.
Post hospital syndrome is an easy problem to overlook, but one that can be prevented. Providing the highest level of patient care requires that doctors be aware of the causes, effects, and prevention strategies for post hospital syndrome, and respond accordingly. In doing so, doctors have the opportunity to provide a better quality of care by preventing problems before the develop.