Mortality in the Oldest-Old Adults After Discharge From Acute Geriatric Ward

Aim: To examine risk factors for post-discharge mortality in the oldest-old patients. Methods: We have assessed the risk factors for mortality after discharge from acute geriatric ward in 448 patients aged ≥90. Results: Low albumin, high urea, and full dependence were risk factors for mortality within 1 month and within 1 year after discharge from hospital. Age-adjusted Charlson Comorbidity Index score, neuroleptic drug treatments and frailty were specific risk factors for post-discharge mortality within 1 year. By Cox regression analysis, the risk factors associated with higher hazard ratios for post-discharge mortality within 14 years follow-up were age-adjusted Charlson Comorbidity Index score, poor functional status, anemia and dementia as comorbidities, neuroleptic drug treatments, low albumin, high urea, and high vitamin B12. Conclusion: Optimal treatment of the condition due to which the patient has been hospitalized and of the medical complications that occurred during hospitalization, while preventing functional decline, might secure longer post-discharge survival.

[1]  F. Sofi,et al.  Predictors of Mortality in 433 Nonagenarians Inside the Mugello Study: A 10 Years Follow-Up Study , 2022, Journal of aging and health.

[2]  B. Wolffenbuttel,et al.  Relationship between serum B12 concentrations and mortality: experience in NHANES , 2020, BMC Medicine.

[3]  G. Navis,et al.  Association of Plasma Concentration of Vitamin B12 With All-Cause Mortality in the General Population in the Netherlands , 2020, JAMA network open.

[4]  P. Lindenauer,et al.  The association of cognitive impairment as screened by the Mini-Cog with long term post-hospitalization outcomes. , 2019, Archives of gerontology and geriatrics.

[5]  R. Hojs,et al.  Anemia on admission and long-term mortality risk in patients with acute ischemic stroke. , 2019, Advances in clinical and experimental medicine : official organ Wroclaw Medical University.

[6]  Chang-ming Huang,et al.  Age-adjusted Charlson Comorbidity Index (ACCI) is a significant factor for predicting survival after radical gastrectomy in patients with gastric cancer , 2019, BMC Surgery.

[7]  N. Mashav,et al.  Which laboratory malnutrition markers best predict 1-year mortality in hospitalized older adults? , 2019, European Geriatric Medicine.

[8]  M. L. Lebrão,et al.  Markers of nutritional status and mortality in older adults: The role of anemia and hypoalbuminemia , 2018, Geriatrics & gerontology international.

[9]  J. Decruyenaere,et al.  Critically ill octogenarians and nonagenarians: evaluation of long-term outcomes, posthospital trajectories and quality of life one year and seven years after ICU discharge. , 2017, Minerva Anestesiologica.

[10]  Koen Milisen,et al.  Effect of anaemia on hand grip strength, walking speed, functionality and 1 year mortality in older hospitalized patients , 2016, BMC Geriatrics.

[11]  Dongfeng Zhang,et al.  Association between Antipsychotic Drugs and Mortality in Older Persons with Alzheimer's Disease: A Systematic Review and Meta-Analysis. , 2016, Journal of Alzheimer's disease : JAD.

[12]  S. Zuidema,et al.  The Mortality Risk of Conventional Antipsychotics in Elderly Patients: A Systematic Review and Meta-analysis of Randomized Placebo-Controlled Trials. , 2015, Journal of the American Medical Directors Association.

[13]  D. Cuadras,et al.  Serum albumin and health in older people: Review and meta analysis. , 2015, Maturitas.

[14]  A. Kasiukiewicz,et al.  Prognostic factors of long-term survival in geriatric inpatients. Should we change the recommendations for the oldest people? , 2015, The journal of nutrition, health & aging.

[15]  H. Sørensen,et al.  Elevated Plasma Vitamin B12 Levels as a Marker for Cancer: A Population-Based Cohort Study , 2013, Journal of the National Cancer Institute.

[16]  P. Saavedra-Santana,et al.  Five-year survival and prognostic factors in a cohort of hospitalized nonagenarians. , 2012, European journal of internal medicine.

[17]  T. Masud,et al.  Functional level at admission is a predictor of survival in older patients admitted to an acute geriatric unit , 2012, BMC Geriatrics.

[18]  Y. Berner,et al.  Are atypical antipsychotics safer than typical antipsychotics for treating behavioral and psychological symptoms of dementia? , 2012, The journal of nutrition, health & aging.

[19]  B. Buurman,et al.  Clinical Characteristics and Outcomes of Hospitalized Older Patients with Distinct Risk Profiles for Functional Decline: A Prospective Cohort Study , 2012, PloS one.

[20]  J. Losa,et al.  Mortality and complications in very old patients (90+) admitted to departments of internal medicine in Spain. , 2011, European journal of internal medicine.

[21]  K. Krause,et al.  Mild cognitive impairment, degenerative and vascular dementia as predictors of intra-hospital, short- and long-term mortality in the oldest old , 2011, Aging clinical and experimental research.

[22]  M. Guil,et al.  Impact of Dementia on Hospitalization , 2010, Neuroepidemiology.

[23]  S. Malnick,et al.  Association Between Vitamin B12 Levels and Mortality in Hospitalized Older Adults , 2010, Journal of the American Geriatrics Society.

[24]  Chin-Li Lu,et al.  Elevated Serum Vitamin B12 Levels in Association With Tumor Markers as the Prognostic Factors Predictive for Poor Survival in Patients With Hepatocellular Carcinoma , 2010, Nutrition and cancer.

[25]  E. Sampson,et al.  Dementia in the acute hospital: prospective cohort study of prevalence and mortality , 2009, British Journal of Psychiatry.

[26]  F. Herrmann,et al.  High vitamin B12 level and mortality in elderly inpatients , 2008, The journal of nutrition, health & aging.

[27]  F. Formiga,et al.  Predictive items of one-year mortality in nonagenarians. The NonaSantfeliu Study , 2007, Aging clinical and experimental research.

[28]  D. Raveh,et al.  Clinical and demographic characteristics of elderly patients hospitalised in an internal medicine department in Israel , 2007, International journal of clinical practice.

[29]  C. Moran,et al.  Mortality and serum urea and electrolytes on admission for hip fracture patients. , 2006, Injury.

[30]  M. Kuzuya,et al.  Underappreciated Predictors for Postdischarge Mortality in Acute Hospitalized Oldest-Old Patients , 2006, Gerontology.

[31]  A. Weaver,et al.  Prescription Use and Survival Among Nonagenarians Presenting to the Emergency Department , 2005 .

[32]  Randall C. Thompson,et al.  Relation of anemia at discharge to survival after acute coronary syndromes. , 2005, The American journal of cardiology.

[33]  F. Herrmann,et al.  HIGH VITAMIN B12 LEVEL: A STRONG PREDICTOR OF MORTALITY IN ELDERLY INPATIENTS , 2005, Journal of the American Geriatrics Society.

[34]  Peter J Pronovost,et al.  A systematic review of the Charlson comorbidity index using Canadian administrative databases: a perspective on risk adjustment in critical care research. , 2005, Journal of critical care.

[35]  L. Rubenstein,et al.  Risk factors for early and late mortality in hospitalized older patients: the continuing importance of functional status. , 2003, The journals of gerontology. Series A, Biological sciences and medical sciences.

[36]  M. Trabucchi,et al.  Predicting mortality in older patients. The VELCA Study , 2003, Aging clinical and experimental research.

[37]  D. Sullivan.  What do the serum proteins tell us about our elderly patients? , 2001, The journals of gerontology. Series A, Biological sciences and medical sciences.

[38]  R. Fortinsky,et al.  Development and validation of a prognostic index for 1-year mortality in older adults after hospitalization. , 2000, JAMA.

[39]  W. Frishman,et al.  THE ASSOCIATION OF VITAMIN B12 AND FOLATE BLOOD LEVELS WITH MORTALITY AND CARDIOVASCULAR MORBIDITY INCIDENCE IN THE OLD OLD: THE BRONX AGING STUDY , 1997, American journal of therapeutics.

[40]  R. Incalzi,et al.  Predicting mortality and length of stay of geriatric patients in an acute care general hospital. , 1992, Journal of gerontology.

[41]  L. Rubenstein,et al.  Predictors of Immediate and 6‐Month Outcomes in Hospitalized Elderly Patients , 1988, Journal of the American Geriatrics Society.

[42]  H. Bitterman,et al.  Nonagenarians in internal medicine: characteristics, outcomes and predictors for in-hospital and post-discharge mortality. , 2010, The Israel Medical Association journal : IMAJ.

[43]  E. Andrès,et al.  An update on cobalamin deficiency in adults. , 2009, QJM : monthly journal of the Association of Physicians.

[44]  D. Shahar,et al.  High prevalence and impact of subnormal serum vitamin B12 levels in Israeli elders admitted to a geriatric hospital. , 2001, The journal of nutrition, health & aging.

[45]  C. Verny,et al.  Hospitalisation en médecine interne des nonagénaires. Étude de 150 séjours , 1993 .

[46]  C. Mackenzie,et al.  A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. , 1987, Journal of chronic diseases.