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Combined effects of four major geriatric syndromes on adverse outcomes based on Korean National Health Insurance claims data.
Geriatr Gerontol Int. 2018 Oct; 18(10):1463-1468.GG

Abstract

AIM

Geriatric syndromes are common among older individuals, and can affect their health and quality of life. The present study aimed to determine if combinations of geriatric syndromes affected adverse outcomes among older Koreans.

METHODS

Korean national health insurance data were collected for a cohort of 5 058 720 individuals who were aged ≥65 years in 2008. The same data source was used to follow these individuals until 2015. Diagnostic codes were used to assess four major geriatric syndromes (delirium, fall-related fractures, incontinence and pressure ulcers) and adverse outcomes (mortality and nursing home institutionalization).

RESULTS

The prevalence of geriatric syndromes was 0.3% for delirium, 3.49% for fall-related fractures, 1.08% for incontinence and 0.82% for pressure ulcers. All four geriatric syndromes were associated with increased risks of institutionalization (adjusted hazard ratio [aHR] 2.18, 95% CI 2.08-2.17 for delirium; aHR 1.59, 95% CI 1.58-1.60 for fall-related fractures; aHR 1.43, 95% CI 1.41-1.44 for incontinence; and aHR 2.51, 95% CI 2.47-2.55 for pressure ulcers) and increased risks of mortality (aHR 2.13, 95% CI 2.08-2.17 for delirium; aHR 1.41, 95% CI 1.40-1.42 for fall-related fractures; aHR 1.09, 95% CI 1.07-1.10 for incontinence; and aHR 3.23, 95% CI 3.20-3.27 for pressure ulcers). The aHR for institutionalization were 1.64 (95% CI 1.63-1.65) for one geriatric syndrome, 2.40 (95% CI 2.35-2.44) for two coexisting geriatric syndromes and 2.56 (95% CI 2.35-2.74) for three coexisting geriatric syndromes. The aHR for mortality were 1.52 (95% CI 1.51-1.53) for one geriatric syndrome, 2.36 (95% CI 2.32-2.40) for two coexisting geriatric syndromes and 2.90 (95% CI 2.72-3.09) for three coexisting geriatric syndromes.

CONCLUSIONS

Delirium, fall-related fractures, incontinence and pressure ulcers were associated with increased risks of institutionalization and mortality. The magnitude of these risks increased with increasing numbers of coexisting geriatric syndromes. Geriatr Gerontol Int 2018; 18: 1463-1468.

Authors+Show Affiliations

Department of Family Medicine, Kyung Hee University Medical Center, Seoul, Korea.Big Data Steering Department, National Health Insurance Service, Wonju, Korea.Department of Family Medicine, Kyung Hee University Medical Center, Seoul, Korea. Department of Family Medicine, College of Medicine, Kyung Hee University, Seoul, Korea.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30225961

Citation

Kim, Sunyoung, et al. "Combined Effects of Four Major Geriatric Syndromes On Adverse Outcomes Based On Korean National Health Insurance Claims Data." Geriatrics & Gerontology International, vol. 18, no. 10, 2018, pp. 1463-1468.
Kim S, Park JH, Won CW. Combined effects of four major geriatric syndromes on adverse outcomes based on Korean National Health Insurance claims data. Geriatr Gerontol Int. 2018;18(10):1463-1468.
Kim, S., Park, J. H., & Won, C. W. (2018). Combined effects of four major geriatric syndromes on adverse outcomes based on Korean National Health Insurance claims data. Geriatrics & Gerontology International, 18(10), 1463-1468. https://doi.org/10.1111/ggi.13513
Kim S, Park JH, Won CW. Combined Effects of Four Major Geriatric Syndromes On Adverse Outcomes Based On Korean National Health Insurance Claims Data. Geriatr Gerontol Int. 2018;18(10):1463-1468. PubMed PMID: 30225961.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Combined effects of four major geriatric syndromes on adverse outcomes based on Korean National Health Insurance claims data. AU - Kim,Sunyoung, AU - Park,Jong-Heon, AU - Won,Chang Won, Y1 - 2018/09/17/ PY - 2018/04/12/received PY - 2018/07/06/revised PY - 2018/07/14/accepted PY - 2018/9/19/pubmed PY - 2019/1/31/medline PY - 2018/9/19/entrez KW - delirium KW - falls KW - incontinence KW - multimorbidities SP - 1463 EP - 1468 JF - Geriatrics & gerontology international JO - Geriatr Gerontol Int VL - 18 IS - 10 N2 - AIM: Geriatric syndromes are common among older individuals, and can affect their health and quality of life. The present study aimed to determine if combinations of geriatric syndromes affected adverse outcomes among older Koreans. METHODS: Korean national health insurance data were collected for a cohort of 5 058 720 individuals who were aged ≥65 years in 2008. The same data source was used to follow these individuals until 2015. Diagnostic codes were used to assess four major geriatric syndromes (delirium, fall-related fractures, incontinence and pressure ulcers) and adverse outcomes (mortality and nursing home institutionalization). RESULTS: The prevalence of geriatric syndromes was 0.3% for delirium, 3.49% for fall-related fractures, 1.08% for incontinence and 0.82% for pressure ulcers. All four geriatric syndromes were associated with increased risks of institutionalization (adjusted hazard ratio [aHR] 2.18, 95% CI 2.08-2.17 for delirium; aHR 1.59, 95% CI 1.58-1.60 for fall-related fractures; aHR 1.43, 95% CI 1.41-1.44 for incontinence; and aHR 2.51, 95% CI 2.47-2.55 for pressure ulcers) and increased risks of mortality (aHR 2.13, 95% CI 2.08-2.17 for delirium; aHR 1.41, 95% CI 1.40-1.42 for fall-related fractures; aHR 1.09, 95% CI 1.07-1.10 for incontinence; and aHR 3.23, 95% CI 3.20-3.27 for pressure ulcers). The aHR for institutionalization were 1.64 (95% CI 1.63-1.65) for one geriatric syndrome, 2.40 (95% CI 2.35-2.44) for two coexisting geriatric syndromes and 2.56 (95% CI 2.35-2.74) for three coexisting geriatric syndromes. The aHR for mortality were 1.52 (95% CI 1.51-1.53) for one geriatric syndrome, 2.36 (95% CI 2.32-2.40) for two coexisting geriatric syndromes and 2.90 (95% CI 2.72-3.09) for three coexisting geriatric syndromes. CONCLUSIONS: Delirium, fall-related fractures, incontinence and pressure ulcers were associated with increased risks of institutionalization and mortality. The magnitude of these risks increased with increasing numbers of coexisting geriatric syndromes. Geriatr Gerontol Int 2018; 18: 1463-1468. SN - 1447-0594 UR - https://www.unboundmedicine.com/medline/citation/30225961/Combined_effects_of_four_major_geriatric_syndromes_on_adverse_outcomes_based_on_Korean_National_Health_Insurance_claims_data_ L2 - https://doi.org/10.1111/ggi.13513 DB - PRIME DP - Unbound Medicine ER -