Abstract
Background & Objective: White matter hyperintensities (WMHs) contribute
to aggravation of dementia or geriatric syndrome, thereby resulting in functional
impairment. However, evidence of direct association between WMHs and medical resource
utilization indicated by length of hospital stay (LOS) is scarce in patients with
cognitive impairment. This study aimed to examine the relationship between the severity of
WMHs and LOS in patients with cognitive impairment.
Methods: 4,253 older adults with cognitive impairment were enrolled in this
study. We defined LOS as the total sum of days from January 1, 2008 to December 31, 2012.
The severity of periventricular (PVWMHs), deep (DWMHs), and overall white matter
hyperintensities (Overall WMHs) was evaluated by a visual rating scale. We conducted
multinomial logistic regression to demonstrate the relationship between LOS and severity
of PVWHMs, DWHMs, and Overall WMHs, respectively.
Results: The median LOS was 20 days. Severe PVWMHs had a higher likelihood of
longer LOS (Q3: odd ratio/OR = 1.32, 95% confidence interval/CI = 1.06–1.64; Q4:
OR = 1.33, 95% CI = 1.07–1.65; Q5: OR = 1.55, 95% CI = 1.26–1.91). As for DWMHs, moderate
DWMHs were related to longer LOS (Q4: OR = 1.33, 95% CI = 1.03–1.71; Q5: OR = 1.63, 95%
CI = 1.26–2.11). Finally, severity of overall WMHs was independently associated with LOS,
which was similar to the results of DWMHs.
Conclusion: These findings would advocate for prevention of WMHs to stave off
excess medical resource utilization in patients with cognitive impairment.
