Nonlinear Relationship Between Vital Signs and Hospitalization/Emergency Department Visits Among Older Home Healthcare Patients and Critical Vital Sign Cutoff for Adverse Outcomes: Application of Generalized Additive Model

Se Hee Min, Jiyoun Song, Lauren Evans, Kathryn H. Bowles, Margaret V. McDonald, Sena Chae, Sridevi Sridharan, Yolanda Barrón and Maxim Topaz

Clinical Nursing Research, 2025, vol. 34, issue 7, 364-376

Abstract: Previous studies have focused on identifying risk factors for older adults receiving home healthcare services without considering vital signs. This may provide important information on deteriorating health conditions that may lead to hospitalization and/or emergency department (ED) visits. Thus, it is important to understand the relationship between vital signs and hospitalization and/or ED visits and critical vital sign points for mitigating the higher risks of hospitalization and/or ED visits. This secondary data analysis uses cross-sectional data from a large, urban home healthcare organization ( n  = 61,615). A generalized additive model was used to understand the nonlinear relationship between each vital sign and hospitalization and/or ED visits through three unadjusted and adjusted models, and to identify a critical vital sign point related to a higher risk of hospitalization and/or ED visits. A significant nonlinear relationship (effective degree of freedom >2.0) was found between systolic, diastolic blood pressure, heart rate, hospitalization, and/or ED visits. The critical inflection point for systolic blood pressure was 120.36 (SE 3.625, p  

Keywords: Adverse outcome; aging; biomarker; home healthcare; older adults (search for similar items in EconPapers)
Date: 2025
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Persistent link: https://EconPapers.repec.org/RePEc:sae:clnure:v:34:y:2025:i:7:p:364-376

DOI: 10.1177/10547738251336488

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