Predictive factors of hospital and 6-month morbidity and mortality in hospitalized elderly patients.

Authors

  • Sílvia Sousa Serviço de Medicina Interna, Hospital de Egas Moniz, Lisboa.
  • M F Moraes
  • V Beato
  • A S Corredoura
  • G Rodrigues
  • M Soares
  • T Lourenço
  • C Gomes
  • F Godinho
  • L Oliveira
  • A P Santos
  • C Soares
  • T P Ribeiro
  • L Jordão
  • G Menitra
  • P Aguiar
  • J Pimenta Graça
  • P Abecasis

DOI:

https://doi.org/10.20344/amp.1930

Abstract

This article presents the results of a prospective multivariable study of elderly patients aged over 70 years, hospitalized in an Internal Medicine Department of a Central Lisbon Hospital. The study aimed to identify, at the beginning of hospital admission (HA), predictive factors of hospital mortality (HM) and mortality at 6 months, of duration of HA, of admission to a nursing home at the time of discharge and during a period of 6 months thereafter and of hospital readmission during the 6 months following discharge. The study included 158 patients with a mean hospital stay of 15 days and a hospital mortality of 12%. The main pathologies responsible for hospital admission were cerebrovascular accident (22%), heart failure (20%) and pneumonia (16%). Mortality at 6 months was 29% and hospital readmission in the 6 months thereafter was 24%. When the patient was cared for by the spouse there was a statistically significant correlation with a shorter duration of admission (p = 0.006). Mean hospital stay was not significantly associated with any other variable. A subjective medical evaluation (SME) at the start of HA (p = 0.001), a low Barthel score prior to and at the time of HA, low serum albumin (p = 0.001) and a high leucocyte count (p = 0.005) were correlated with a higher HM. Nursing home admission was only positively correlated with cerebrovascular pathology. Mortality at 6 months was significantly correlated with the SME (p = 0.001), a low Barthel score prior to admission (p < 0.008) and at the time of HA (p < 0.001), nursing home residency (p < 0.005) and a low mental test score (p < 0.01). Hospital readmission at 6 months was influenced by the SME (p < 0.04) and by the reduction in the Barthel score caused by the illness and HA (p = 0.004). These correlations enabled the development of mathematical models that predict HM and mortality at 6 months and admission to a nursing home at the time of discharge and during a period of 6 months thereafter. They could be important in identifying elderly patients' needs early in the hospital admission and in the improvement of the strategy necessary for a successful and dignified hospital discharge.

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How to Cite

1.
Sousa S, Moraes MF, Beato V, Corredoura AS, Rodrigues G, Soares M, Lourenço T, Gomes C, Godinho F, Oliveira L, Santos AP, Soares C, Ribeiro TP, Jordão L, Menitra G, Aguiar P, Graça JP, Abecasis P. Predictive factors of hospital and 6-month morbidity and mortality in hospitalized elderly patients. Acta Med Port [Internet]. 2002 Jun. 30 [cited 2024 Mar. 29];15(3):177-84. Available from: https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/1930

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Section

Arquivo Histórico