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BMC Geriatr. 2008 May 14;8:10. doi: 10.1186/1471-2318-8-10.

Adverse outcomes following hospitalization in acutely ill older patients.

Author information

1
Division of Geriatric Medicine, Department of Medicine, University of British Columbia, Canada. rymwong@interchange.ubc.ca

Abstract

BACKGROUND:

The longitudinal outcomes of patients admitted to acute care for elders units (ACE) are mixed. We studied the associations between socio-demographic and functional measures with hospital length of stay (LOS), and which variables predicted adverse events (non-independent living, readmission, death) 3 and 6 months later.

METHODS:

Prospective cohort study of community-living, medical patients age 75 or over admitted to ACE at a teaching hospital.

RESULTS:

The population included 147 subjects, median LOS of 9 days (interquartile range 5-15 days). All returned home/community after hospitalization. Just prior to discharge, baseline timed up and go test (TUG, P < 0.001), bipedal stance balance (P = 0.001), and clinical frailty scale scores (P = 0.02) predicted LOS, with TUG as the only independent predictor (P < 0.001) in multiple regression analysis. By 3 months, 59.9% of subjects remained free of an adverse event, and by 6 months, 49.0% were event free. The 3 and 6-month mortality was 10.2% and 12.9% respectively. Almost one-third of subjects had developed an adverse event by 6 months, with the highest risk within the first 3 months post discharge. An abnormal TUG score was associated with increased adjusted hazard ratio [HR] 1.28, 95% confidence interval [CI] 1.03 to 1.59, P = 0.03. A higher FMMSE score (adjusted HR 0.89, 95% CI 0.82 to 0.96, P = 0.003) and independent living before hospitalization (adjusted HR 0.42, 95% CI 0.21 to 0.84, P = 0.01) were associated with reduced risk of adverse outcome.

CONCLUSION:

Some ACE patients demonstrate further functional decline following hospitalization, resulting in loss of independence, repeat hospitalization, or death. Abnormal TUG is associated with prolonged LOS and future adverse outcomes.

PMID:
18479512
PMCID:
PMC2391142
DOI:
10.1186/1471-2318-8-10
[Indexed for MEDLINE]
Free PMC Article

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