International Journal of Gerontology
Mortality and Prognostic Factors in Patients over 90 Years of Age Admitted in Internal Medicine: A Spanish Prospective Cohort Study
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Background: The prevalence of multimorbidity and the number of chronic pathologies increases with age, and hospitalization rates are higher in very elderly patients.
Aims: To identify predictors of mortality in patients aged 90 years or more at 6 and 12 months after admission to the internal medicine ward.
Materials and methods: Prospective cohort study in patients aged 90 years or older whowere admitted to the internal medicine ward of Alicante General University Hospital from November 2018 to March 2019. We collected data for patient scores on the Barthel, Lawton-Brody, and Short Portable Mental Status Questionnaire; a nutritional questionnaire; the Charlson index; PALIAR and PROFUND prognostic indexes; and mortality at 6 and 12 months.
Results: In the bivariate analysis adjusted for gender and comorbidity, malnutrition was associated with mortality at 6 and 12 months (odds ratio [OR] 5.17, 95% confidence interval [CI] 1.30, 20.50; OR 7.78, 95% CI 1.47, 40.9, respectively), as were moderate-severe cognitive impairment (6 months: OR 12.0, 95% CI 2.79, 52.0; 12 months: OR 10.73, 95% CI 2.40, 47.8) and high-risk scores on the PALIAR (6 months: OR 9.18, 95% CI 1.99, 42.27; 12 months: OR 11.7, 95% CI 2.62, 51.60) and PROFUND (6 months: OR 10.7, 95% CI 1.68, 68.80; 12 months: OR 20.9, 95% CI 3.15, 139.0) prognostic indexes. The Barthel index was associated with mortality only at 6 months (OR 6.16; 95% CI 1.69, 22.4).
Conclusions: In nonagenarian inpatients, a worse score on the comprehensive assessment and a higher score on prognostic indexes were associated with increased risk of mortality at 6 and 12 months.