Age and Ageing, Vol 28, 429-432, Copyright © 1999 by British Geriatrics Society
T Alarcon, A Barcena, JI Gonzalez-Montalvo, C Penalosa and A Salgado
AIM: To investigate which factors predict outcome of elderly patients on
discharge and at 6 months. METHODS: A prospective study in an acute
geriatric ward. Within 48 h of admission, patients were assessed for social
factors, geriatric problems, admission diagnoses, medication, function and
mental ability. Outcome measures were mortality, length of stay,
institutionalization, readmissions and attendance at accident and emergency
within 6 months. RESULTS: 353 patients were studied, with a mean age of
81.8 years. Logistic regression analyses showed that variables predicting
hospital mortality were Barthel index on admission, pre-morbid disability
and polypharmacy. The only variable independently predictive of prolonged
stay in hospital was a Barthel score of <45 on admission. Functional
disability on admission was predictive of institutionalization on
discharge. Variables predicting mortality within 6 months of discharge were
Barthel index on admission <65, presence of pressure sores, malnutrition
and polypharmacy. Variables independently predictive of
institutionalization were mental state and a low pension. Those who took
more than five drugs on admission were more likely to attend accident and
emergency and be readmitted. CONCLUSION: Limited activities of daily living
and geriatric problems on admission are the strongest predictive factors of
outcome, independent of diagnoses.
ARTICLES
Factors predictive of outcome on admission to an acute geriatric ward
Unidad de Valoracion Geriatrica, Hospital Universitario La Paz, Madrid, Spain.
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