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[Co-morbidity in acutely hospitalised older patients as a risk factor for death in hospital or within 3 months after discharge].
Ned Tijdschr Geneeskd 2007; 151(36):1987-93NT

Abstract

OBJECTIVE

To study the presence of co-morbidity and delirium and to determine whether these factors are predictors of hospital and shortterm mortality in elderly patients acutely admitted to a department of internal medicine.

DESIGN

Prospective cohort study.

METHOD

Social and demographic data as well as data on their physical and cognitive limitations were collected from consecutive patients of 65 years and older who were hospitalised in the period from I December 2002 to 30 June 2005 in the Academic Medical Centre in Amsterdam, the Netherlands. Co-morbidity and ICD diagnosis were determined on discharge from the hospital. Three months after discharge the patients' circumstances were assessed.

RESULTS

A total of 461 patients, 195 men and 266 women with an average age of 78.2 years (SD: 7.8), were included. Of these patients, 132 (28.6%) had cognitive impairment and the mean number of limitations with regard to the activities of daily living (ADL) was 5.48 (10.4%) patients died in hospital and another 74 patients (16.1%) had died 3 months after discharge. The only independent predictor of hospital mortality was delirium at admission (OR: 2.28; 95% CI: 1.23-4.21). Independent risk factors for mortality within 3 months after discharge were: delirium at admission (OR: 2.20; 95% CI: 1.12-4.31), pre-admission ADL limitations (OR: 1.11; 95% CI: 1.02-1.21), a diagnosed malignancy (OR: 5.96; 95% CI: 2.45-14-52), and a higher Charlson co-morbidity index (OR: 1.19; 95% CI: 1.04-1-34).

CONCLUSION

At discharge from the hospital, the risk of death within 3 months after discharge in acutely hospitalised patients of 65 years and older was determined by a combination of delirium at admission, pre-admission ADL limitations, a malignancy, and co-morbidity. These results can be used to identify elderly patients who might benefit from comprehensive geriatric assessment during hospitalisation and from a well-prepared discharge planning that takes their co-morbidity into consideration.

Authors+Show Affiliations

Academisch Medisch Centrum/Universiteit van Amsterdam, Postbus 22.700, 1100 DE Amsterdam. s.e.derooij@amc.uva.nlNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

English Abstract
Journal Article

Language

dut

PubMed ID

17953173

Citation

de Rooij, S E., et al. "[Co-morbidity in Acutely Hospitalised Older Patients as a Risk Factor for Death in Hospital or Within 3 Months After Discharge]." Nederlands Tijdschrift Voor Geneeskunde, vol. 151, no. 36, 2007, pp. 1987-93.
de Rooij SE, Buurman BM, korevaar JC, et al. [Co-morbidity in acutely hospitalised older patients as a risk factor for death in hospital or within 3 months after discharge]. Ned Tijdschr Geneeskd. 2007;151(36):1987-93.
de Rooij, S. E., Buurman, B. M., korevaar, J. C., Van Munster, B. C., Schuurmans, M. J., Laqaaij, A. M., ... Levi, M. (2007). [Co-morbidity in acutely hospitalised older patients as a risk factor for death in hospital or within 3 months after discharge]. Nederlands Tijdschrift Voor Geneeskunde, 151(36), pp. 1987-93.
de Rooij SE, et al. [Co-morbidity in Acutely Hospitalised Older Patients as a Risk Factor for Death in Hospital or Within 3 Months After Discharge]. Ned Tijdschr Geneeskd. 2007 Sep 8;151(36):1987-93. PubMed PMID: 17953173.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Co-morbidity in acutely hospitalised older patients as a risk factor for death in hospital or within 3 months after discharge]. AU - de Rooij,S E, AU - Buurman,B M, AU - korevaar,J C, AU - Van Munster,B C, AU - Schuurmans,M J, AU - Laqaaij,A M, AU - Verhaar,H J J, AU - Levi,M, PY - 2007/10/24/pubmed PY - 2007/11/10/medline PY - 2007/10/24/entrez SP - 1987 EP - 93 JF - Nederlands tijdschrift voor geneeskunde JO - Ned Tijdschr Geneeskd VL - 151 IS - 36 N2 - OBJECTIVE: To study the presence of co-morbidity and delirium and to determine whether these factors are predictors of hospital and shortterm mortality in elderly patients acutely admitted to a department of internal medicine. DESIGN: Prospective cohort study. METHOD: Social and demographic data as well as data on their physical and cognitive limitations were collected from consecutive patients of 65 years and older who were hospitalised in the period from I December 2002 to 30 June 2005 in the Academic Medical Centre in Amsterdam, the Netherlands. Co-morbidity and ICD diagnosis were determined on discharge from the hospital. Three months after discharge the patients' circumstances were assessed. RESULTS: A total of 461 patients, 195 men and 266 women with an average age of 78.2 years (SD: 7.8), were included. Of these patients, 132 (28.6%) had cognitive impairment and the mean number of limitations with regard to the activities of daily living (ADL) was 5.48 (10.4%) patients died in hospital and another 74 patients (16.1%) had died 3 months after discharge. The only independent predictor of hospital mortality was delirium at admission (OR: 2.28; 95% CI: 1.23-4.21). Independent risk factors for mortality within 3 months after discharge were: delirium at admission (OR: 2.20; 95% CI: 1.12-4.31), pre-admission ADL limitations (OR: 1.11; 95% CI: 1.02-1.21), a diagnosed malignancy (OR: 5.96; 95% CI: 2.45-14-52), and a higher Charlson co-morbidity index (OR: 1.19; 95% CI: 1.04-1-34). CONCLUSION: At discharge from the hospital, the risk of death within 3 months after discharge in acutely hospitalised patients of 65 years and older was determined by a combination of delirium at admission, pre-admission ADL limitations, a malignancy, and co-morbidity. These results can be used to identify elderly patients who might benefit from comprehensive geriatric assessment during hospitalisation and from a well-prepared discharge planning that takes their co-morbidity into consideration. SN - 0028-2162 UR - https://www.unboundmedicine.com/medline/citation/17953173/[Co_morbidity_in_acutely_hospitalised_older_patients_as_a_risk_factor_for_death_in_hospital_or_within_3_months_after_discharge]_ L2 - https://medlineplus.gov/delirium.html DB - PRIME DP - Unbound Medicine ER -