» Articles » PMID: 22731680

Functional Level at Admission is a Predictor of Survival in Older Patients Admitted to an Acute Geriatric Unit

Overview
Journal BMC Geriatr
Publisher Biomed Central
Specialty Geriatrics
Date 2012 Jun 27
PMID 22731680
Citations 25
Authors
Affiliations
Soon will be listed here.
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 was studied 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 December 31st 2009 were included. Data on BI, sex, age, and discharge diagnoses were retrieved from the hospital patient administrative system, and data on survival until September 6th 2010 were retrieved from the Civil Personal Registry. Co-morbidity was measured with Charlson Co-morbidity Index (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 81.8 (6.8) and 83.9 (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 as baseline and controlling for significant covariates (sex, age, CCI, and diseases of cancer, haematology, cardiovascular, respiratory, infectious and bone and connective tissues) the odds 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) and 0.29 (0.24-0.35)(p < 0.001) respectively.

Conclusion: BI is a strong independent predictor of survival in older patients admitted to an acute geriatric unit. These data suggest that assessment of ADL may have a potential role in decision making for the clinical management of frail geriatric inpatients.

Citing Articles

Probable Respiratory Sarcopenia Decreases Activities of Daily Living in Older Patients Hospitalized with Respiratory Diseases: A Cross-sectional Study.

Moriyama T, Tokunaga M, Hori R, Itoh H, Hachisuka A, Ochi M Prog Rehabil Med. 2024; 9:20240014.

PMID: 38617808 PMC: 11009035. DOI: 10.2490/prm.20240014.


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

Tal S Gerontol Geriatr Med. 2023; 9:23337214231156300.

PMID: 37250599 PMC: 10214041. DOI: 10.1177/23337214231156300.


Validation of the Barthel Index as a Predictor of In-Hospital Mortality among COVID-19 Patients.

Mateos-Arroyo J, Zaragoza-Garcia I, Sanchez-Gomez R, Posada-Moreno P, Ortuno-Soriano I Healthcare (Basel). 2023; 11(9).

PMID: 37174880 PMC: 10178780. DOI: 10.3390/healthcare11091338.


Does geriatric follow-up visits reduce hospital readmission among older patients discharged to temporary care at a skilled nursing facility: a before-and-after cohort study.

Thomsen K, Fournaise A, Matzen L, Andersen-Ranberg K, Ryg J BMJ Open. 2021; 11(8):e046698.

PMID: 34389564 PMC: 8365788. DOI: 10.1136/bmjopen-2020-046698.


Activity of daily living upon admission is an independent predictor of in-hospital mortality in older patients with community-acquired pneumonia.

Kang Y, Fang X, Wang D, Wang X BMC Infect Dis. 2021; 21(1):314.

PMID: 33794779 PMC: 8017749. DOI: 10.1186/s12879-021-06006-w.


References
1.
Ranieri P, Bianchetti A, Margiotta A, Virgillo A, Clini E, Trabucchi M . Predictors of 6-month mortality in elderly patients with mild chronic obstructive pulmonary disease discharged from a medical ward after acute nonacidotic exacerbation. J Am Geriatr Soc. 2008; 56(5):909-13. DOI: 10.1111/j.1532-5415.2008.01683.x. View

2.
Christensen K, Doblhammer G, Rau R, Vaupel J . Ageing populations: the challenges ahead. Lancet. 2009; 374(9696):1196-208. PMC: 2810516. DOI: 10.1016/S0140-6736(09)61460-4. View

3.
MAHONEY F, BARTHEL D . FUNCTIONAL EVALUATION: THE BARTHEL INDEX. Md State Med J. 1965; 14:61-5. View

4.
Torres O, Munoz J, Ruiz D, Ris J, Gich I, Coma E . Outcome predictors of pneumonia in elderly patients: importance of functional assessment. J Am Geriatr Soc. 2004; 52(10):1603-9. DOI: 10.1111/j.1532-5415.2004.52492.x. View

5.
Buurman B, van Munster B, Korevaar J, Abu-Hanna A, Levi M, de Rooij S . Prognostication in acutely admitted older patients by nurses and physicians. J Gen Intern Med. 2008; 23(11):1883-9. PMC: 2585689. DOI: 10.1007/s11606-008-0741-7. View