Functional level at admission is a predictor of survival in older patients admitted to an acute geriatric unit

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

ABSTRACT: BACKGROUND: Functional decline is associated with increased risk of mortality in geriatric patients.Assessment of activities of daily living (ADL) with the Barthel Index (BI) at admission wasstudied as a predictor of survival in older patients admitted to an acute geriatric unit. METHODS: All first admissions of patients with age >65 years between January 1st 2005 and December31st 2009 were included. Data on BI, sex, age, and discharge diagnoses were retrieved fromthe hospital patient administrative system, and data on survival until September 6th 2010 wereretrieved from the Civil Personal Registry. Co-morbidity was measured with Charlson ComorbidityIndex (CCI). Patients were followed until death or end of study. RESULTS: 5,087 patients were included, 1,852 (36.4%) men and 3,235 (63.6%) women with mean age(SD) 82.0 (6.8) and 84.0 (7.0) years respectively. The median [IQR] length of stay was 8 days, the median follow up [IQR] 1.4 [0.3; 2.8] years and in hospital mortality 8.2%.Mortality was greater in men than in women with median survival (95%-CI) 1.3 (1.2 -1.5)years and 2.2 (2.1-2.4) years respectively (p <0.001). The median survivals (95%-CI)stratified on BI groups in men (n = 1,653) and women (n = 2,874) respectively were: BI 80-100: 2.6 (1.9-3.1) years and 4.5 (3.9-5.4) years; BI 50-79: 1.7 (1.5-2.1) years and 3.1 (2.7-3.5) years; BI 25-49: 1.5 (1.3-1.9) years and 1.9 (1.5-2.2) years and BI 0-24: 0.5 (0.3-0.7)years and 0.8 (0.6-0.9) years. In multivariate logistic regression analysis with BI 80-100 asbaseline and controlling for significant covariates (sex, age, CCI, and diseases of cancer,haematology, cardiovascular, respiratory, infectious and bone and connective tissues) theodds ratios for 3 and 12 months survival (95%-CI) decreased with declining BI: BI 50-79:0.74 (0.55-0.99) (p <0.05) and 0,80 (0.65-0.97)(p <0.05); BI 25-49: 0.44 (0.33-0.59)(p <0.001) and 0.55 (0.45-0.68)(p <0.001); and BI 0-24: 0.18 (0.14-0.24)(p <0.001) and0.29 (0.24-0.35)(p <0.001) respectively. CONCLUSION: BI is a strong independent predictor of survival in older patients admitted to an acute geriatricunit. These data suggest that assessment of ADL may have a potential role in decisionmaking for the clinical management of frail geriatric inpatients.
OriginalsprogEngelsk
TidsskriftB M C Geriatrics
Vol/bind12
Udgave nummer1
Sider (fra-til)32
Antal sider7
ISSN1471-2318
DOI
StatusUdgivet - 2012

Fingeraftryk

Geriatrics
Patient Admission
Hematology
Hospital Mortality
Information Systems
Connective Tissue
Registries
Inpatients
Length of Stay
Logistic Models
Regression Analysis
Neoplasms

Citer dette

@article{21b634e0cf5c41bf8c49bf439312ae8e,
title = "Functional level at admission is a predictor of survival in older patients admitted to an acute geriatric unit",
abstract = "ABSTRACT: BACKGROUND: Functional decline is associated with increased risk of mortality in geriatric patients.Assessment of activities of daily living (ADL) with the Barthel Index (BI) at admission wasstudied as a predictor of survival in older patients admitted to an acute geriatric unit. METHODS: All first admissions of patients with age >65 years between January 1st 2005 and December31st 2009 were included. Data on BI, sex, age, and discharge diagnoses were retrieved fromthe hospital patient administrative system, and data on survival until September 6th 2010 wereretrieved from the Civil Personal Registry. Co-morbidity was measured with Charlson ComorbidityIndex (CCI). Patients were followed until death or end of study. RESULTS: 5,087 patients were included, 1,852 (36.4{\%}) men and 3,235 (63.6{\%}) women with mean age(SD) 82.0 (6.8) and 84.0 (7.0) years respectively. The median [IQR] length of stay was 8 days, the median follow up [IQR] 1.4 [0.3; 2.8] years and in hospital mortality 8.2{\%}.Mortality was greater in men than in women with median survival (95{\%}-CI) 1.3 (1.2 -1.5)years and 2.2 (2.1-2.4) years respectively (p <0.001). The median survivals (95{\%}-CI)stratified on BI groups in men (n = 1,653) and women (n = 2,874) respectively were: BI 80-100: 2.6 (1.9-3.1) years and 4.5 (3.9-5.4) years; BI 50-79: 1.7 (1.5-2.1) years and 3.1 (2.7-3.5) years; BI 25-49: 1.5 (1.3-1.9) years and 1.9 (1.5-2.2) years and BI 0-24: 0.5 (0.3-0.7)years and 0.8 (0.6-0.9) years. In multivariate logistic regression analysis with BI 80-100 asbaseline and controlling for significant covariates (sex, age, CCI, and diseases of cancer,haematology, cardiovascular, respiratory, infectious and bone and connective tissues) theodds ratios for 3 and 12 months survival (95{\%}-CI) decreased with declining BI: BI 50-79:0.74 (0.55-0.99) (p <0.05) and 0,80 (0.65-0.97)(p <0.05); BI 25-49: 0.44 (0.33-0.59)(p <0.001) and 0.55 (0.45-0.68)(p <0.001); and BI 0-24: 0.18 (0.14-0.24)(p <0.001) and0.29 (0.24-0.35)(p <0.001) respectively. CONCLUSION: BI is a strong independent predictor of survival in older patients admitted to an acute geriatricunit. These data suggest that assessment of ADL may have a potential role in decisionmaking for the clinical management of frail geriatric inpatients.",
author = "Matzen, {Lars E} and Jepsen, {Ditte B} and Jesper Ryg and Tahir Masud",
year = "2012",
doi = "10.1186/1471-2318-12-32",
language = "English",
volume = "12",
pages = "32",
journal = "B M C Geriatrics",
issn = "1471-2318",
publisher = "BioMed Central",
number = "1",

}

Functional level at admission is a predictor of survival in older patients admitted to an acute geriatric unit. / Matzen, Lars E; Jepsen, Ditte B; Ryg, Jesper; Masud, Tahir.

I: B M C Geriatrics, Bind 12, Nr. 1, 2012, s. 32.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Functional level at admission is a predictor of survival in older patients admitted to an acute geriatric unit

AU - Matzen, Lars E

AU - Jepsen, Ditte B

AU - Ryg, Jesper

AU - Masud, Tahir

PY - 2012

Y1 - 2012

N2 - ABSTRACT: BACKGROUND: Functional decline is associated with increased risk of mortality in geriatric patients.Assessment of activities of daily living (ADL) with the Barthel Index (BI) at admission wasstudied as a predictor of survival in older patients admitted to an acute geriatric unit. METHODS: All first admissions of patients with age >65 years between January 1st 2005 and December31st 2009 were included. Data on BI, sex, age, and discharge diagnoses were retrieved fromthe hospital patient administrative system, and data on survival until September 6th 2010 wereretrieved from the Civil Personal Registry. Co-morbidity was measured with Charlson ComorbidityIndex (CCI). Patients were followed until death or end of study. RESULTS: 5,087 patients were included, 1,852 (36.4%) men and 3,235 (63.6%) women with mean age(SD) 82.0 (6.8) and 84.0 (7.0) years respectively. The median [IQR] length of stay was 8 days, the median follow up [IQR] 1.4 [0.3; 2.8] years and in hospital mortality 8.2%.Mortality was greater in men than in women with median survival (95%-CI) 1.3 (1.2 -1.5)years and 2.2 (2.1-2.4) years respectively (p <0.001). The median survivals (95%-CI)stratified on BI groups in men (n = 1,653) and women (n = 2,874) respectively were: BI 80-100: 2.6 (1.9-3.1) years and 4.5 (3.9-5.4) years; BI 50-79: 1.7 (1.5-2.1) years and 3.1 (2.7-3.5) years; BI 25-49: 1.5 (1.3-1.9) years and 1.9 (1.5-2.2) years and BI 0-24: 0.5 (0.3-0.7)years and 0.8 (0.6-0.9) years. In multivariate logistic regression analysis with BI 80-100 asbaseline and controlling for significant covariates (sex, age, CCI, and diseases of cancer,haematology, cardiovascular, respiratory, infectious and bone and connective tissues) theodds ratios for 3 and 12 months survival (95%-CI) decreased with declining BI: BI 50-79:0.74 (0.55-0.99) (p <0.05) and 0,80 (0.65-0.97)(p <0.05); BI 25-49: 0.44 (0.33-0.59)(p <0.001) and 0.55 (0.45-0.68)(p <0.001); and BI 0-24: 0.18 (0.14-0.24)(p <0.001) and0.29 (0.24-0.35)(p <0.001) respectively. CONCLUSION: BI is a strong independent predictor of survival in older patients admitted to an acute geriatricunit. These data suggest that assessment of ADL may have a potential role in decisionmaking for the clinical management of frail geriatric inpatients.

AB - ABSTRACT: BACKGROUND: Functional decline is associated with increased risk of mortality in geriatric patients.Assessment of activities of daily living (ADL) with the Barthel Index (BI) at admission wasstudied as a predictor of survival in older patients admitted to an acute geriatric unit. METHODS: All first admissions of patients with age >65 years between January 1st 2005 and December31st 2009 were included. Data on BI, sex, age, and discharge diagnoses were retrieved fromthe hospital patient administrative system, and data on survival until September 6th 2010 wereretrieved from the Civil Personal Registry. Co-morbidity was measured with Charlson ComorbidityIndex (CCI). Patients were followed until death or end of study. RESULTS: 5,087 patients were included, 1,852 (36.4%) men and 3,235 (63.6%) women with mean age(SD) 82.0 (6.8) and 84.0 (7.0) years respectively. The median [IQR] length of stay was 8 days, the median follow up [IQR] 1.4 [0.3; 2.8] years and in hospital mortality 8.2%.Mortality was greater in men than in women with median survival (95%-CI) 1.3 (1.2 -1.5)years and 2.2 (2.1-2.4) years respectively (p <0.001). The median survivals (95%-CI)stratified on BI groups in men (n = 1,653) and women (n = 2,874) respectively were: BI 80-100: 2.6 (1.9-3.1) years and 4.5 (3.9-5.4) years; BI 50-79: 1.7 (1.5-2.1) years and 3.1 (2.7-3.5) years; BI 25-49: 1.5 (1.3-1.9) years and 1.9 (1.5-2.2) years and BI 0-24: 0.5 (0.3-0.7)years and 0.8 (0.6-0.9) years. In multivariate logistic regression analysis with BI 80-100 asbaseline and controlling for significant covariates (sex, age, CCI, and diseases of cancer,haematology, cardiovascular, respiratory, infectious and bone and connective tissues) theodds ratios for 3 and 12 months survival (95%-CI) decreased with declining BI: BI 50-79:0.74 (0.55-0.99) (p <0.05) and 0,80 (0.65-0.97)(p <0.05); BI 25-49: 0.44 (0.33-0.59)(p <0.001) and 0.55 (0.45-0.68)(p <0.001); and BI 0-24: 0.18 (0.14-0.24)(p <0.001) and0.29 (0.24-0.35)(p <0.001) respectively. CONCLUSION: BI is a strong independent predictor of survival in older patients admitted to an acute geriatricunit. These data suggest that assessment of ADL may have a potential role in decisionmaking for the clinical management of frail geriatric inpatients.

U2 - 10.1186/1471-2318-12-32

DO - 10.1186/1471-2318-12-32

M3 - Journal article

VL - 12

SP - 32

JO - B M C Geriatrics

JF - B M C Geriatrics

SN - 1471-2318

IS - 1

ER -