Mortality predictors six months after discharge from an Acute Geriatric Unit, 2016

Authors

DOI:

https://doi.org/10.24265/horizmed.2017.v17n4.04

Keywords:

Elderly, Aged, Comprehensive health care, Geriatric assessment, Geriatrics, Hospitalized, Hospitalization, Mortality, Predictive

Abstract

Objective: To determine the variables of the comprehensive geriatric assessment (CGA), predictors of mortality six months after discharge of inpatients from the Acute Geriatric Unit (AGU) of the Hospital Nacional Guillermo Almenara Irigoyen. Materials and methods: An observational, prospective, longitudinal study was conducted in the Acute Geriatric Unit of the Hospital Nacional Guillermo Almenara Irigoyen (HNGAI) from July 2015 to January 2016. Variables (general characteristics [age, gender, hospital stay] and comprehensive geriatric assessment [comorbidity, functional assessment, emotional assessment, cognitive assessment and social-family assessment]) were collected from the Geriatric Unit medical records and a mortality-related telephone follow-up was performed six months after discharge. Results: The study population consisted of 110 patients (57.3% were male, age: 77.47 ± 8.92 years, hospital stay: 29.29 ± 44.03 days). Six months after discharge, mortality was 42%. The bivariate analysis showed that variables associated with mortality six months after discharge were greater loss of functional capacity at admission, comorbidity, functional dependence, greater cognitive impairment, and risks and social problems. Cox regression analysis showed that predictors of mortality were loss of functional capacity at admission (PFi) (HR [95% CI] = 1.09 [1.03-1.15]; p = 0.005) and comorbidity (Charlson Index) (HR [95% CI] = 5.74 [0.817-37.75]; p = 0.05). Conclusions: Greater loss of functional capacity and comorbidity were variables of the comprehensive geriatric assessment, predictors of mortality six months after discharge, which allow identifying the risk group, in order to establish intervention strategies to improve the continuity of care process and increase the follow-up time of frail elderly.

Downloads

Download data is not yet available.

References

Rozzini R, Sabatini T, Cassinadri A. Relationship between functional loss before hospital admission and mortality in elderly persons with medical illness. Journal of Gerontology: MedicaL Sciences. 2005;60(9): 1180-3.

Thomas R. Focus on Functional Decline in Hospitalized. Journal of Gerontology: Medical Sciences. 2002; 57(9):567–8.

Naciones Unidas. Informe conciso: La situación demográfica en el mundo, 2014. Nueva York, Estados Unidos: Naciones Unidas; 2014.

CEPAL. La nueva era demográfica en América Latina y el Caribe: la hora de la igualdad según el reloj poblacional. Santiago de Chile, Chile: CEPAL, División de Población (CELADE); 2014.

Situación de la Población Adulta Mayor. Informe Técnico No 1. INEI-Perú; 2015.

Buurman B, Hoogerduijn J, de Haan R, Abu-Hanna A, Lagaay A, Verhaa H, et al. Geriatric Conditions in Acutely Hospitalized Older Patients: Prevalence and One-Year Survival and Functional Decline. PLoS ONE. 2011; 6(11):e26951.

Pérez M, Villegas E, Guallar A, Rosado R, Barbé J y Vilardell M. Utilidad de un nuevo índice pronóstico de mortalidad tras el alta hospitalaria en pacientes mayores de 70 años. Med Clin (Barc). 2006; 127(13):492-3.

Regal-Ramosa R, Salinero-Fortb M, Cruz-Jentoft A. Factores predictores de mortalidad de una cohorte clinica de pacientes ancianos. Atencion Primaria. 2005; 36(9):480-8.

Reuben DB, Rubenstein LV, Hirsch SH. Value of Functional Status as a Predictor of Mortality: Results of a Prospective Study. The American Journal of Medicine. 1992; 93:663-9.

Ávila M. Mortalidad a los 6 meses del alta de la Unidad Geriátrica de Agudos. [tesis] Lima: Universidad Nacional de San Marcos; 2009.

Cabré M, Serra-Prat M, Force L, Palomera E, Pallarés R. Functional status as a risk factor for mortality in very elderly patients with pneumonia. Med Clin (Barc). 2008; 131(5):167-70.

Martínez-Velilla N, Cambra-Contin K, Ibáñez-Beroiz B. Comorbidity and prognostic indices do not improve the 5-year mortality prediction of components of comprehensive geriatric assessment in hospitalized older patients. BMC Geriatrics. 2014; 14(1):64.

Abizanda P, León M, Romero L, Sánchez P, Luengo C, Domínguez L, et lal. La pérdida funcional al ingreso, principal variable explicativa de discapacidad y mortalidad al alta y al mes en ancianos hospitalizados. Revista Española de Geriatría y Gerontología. 2007; 42(4):201-11.

Rozzini R, Sabatini T, Cassinadri A, Boffelli S, Ferri M, Barbisoni P, et al. Relationship Between Functional Loss Before Hospital Admission and Mortality in Elderly Persons With Medical Illness. Journal of Gerontology: MEDICAL SCIENCES. 2005; 60A(9):1180-3.

Ramos M, Romero E, Mora J, Silveira L, Ribera J. Análisis de mortalidad tras el ingreso en una unidad de agudos de geriatría: influencia de la dependencia funcional. Revista Española de Geriatría y Gerontología. 2007; 42(4): 212-7

Scott W, Macera C, Cornman C, Shpe P. Functional Health Status as a Predictor of Mortality in Men and Women Over 65. J Clin Epidemiol. 1997; 50(3):291-6.

Published

2017-12-02

How to Cite

1.
Tuesta-Nole JR, Cieza-Macedo EC. Mortality predictors six months after discharge from an Acute Geriatric Unit, 2016. Horiz Med [Internet]. 2017Dec.2 [cited 2025Jun.20];17(4):19-23. Available from: https://www.horizontemedico.usmp.edu.pe/index.php/horizontemed/article/view/684

Issue

Section

Original article