Key result
Use of more than 6 drugs independently predicted in-hospital mortality among geriatric patients (OR 3.04; 95% CI 1.05-8.76).
Why the study?
What are the admission predictors of in-hospital mortality and extended length of stay in geriatric patients?
Cohort (n=308)
No
What are the admission predictors of in-hospital mortality and extended length of stay in geriatric patients?
Effect estimate: OR 3.04 (95% CI 1.05-8.76)
Polypharmacy, cognitive impairment, and low functional status at admission are independent predictors of in-hospital mortality and extended length of stay in geriatric patients.
Polypharmacy >6 drugs associated with higher geriatric in-hospital mortality; leaves open whether deprescribing improves outcomes.
Three-hundred-eight geriatric patients (mean age = 76.7 yr, range = 70-94 yr) consecutively admitted to an acute care general hospital were followed up to identify the predictors of in-hospital mortality and long stay. Sociodemographic, medical, and functional data were collected within 24 hours from admission and their correlation with the outcomes assessed by logistic regression analysis. The following variables were shown to be independent predictors of death: use of more than 6 drugs (odds ratio = 3.04, confidence limits = 1.05-8.76); abnormal Mini-Mental State score (o.r. = 1.72, c.l. = 1.05-1.83); low ADL score (o.r. = 2.4, c.l. = 1.07-5.56). Extended stay was significantly and independently predicted by polypharmacy (o.r. = 1.94, c.l. = 1.18-3.2) and comorbidity (o.r. = 2.06, c.l. = 1.24-3.38). The mortality rates of patients with cognitive impairment and polypharmacy with or without functional impairment were 40% and 22%, respectively. The proposed method allows identification of high-risk geriatric inpatients by a simple medical and functional assessment on admission.
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Incalzi et al. (1992) conducted a cohort in Geriatric patients admitted to an acute care general hospital (n=308). Polypharmacy (>6 drugs) vs. ≤6 drugs was evaluated on In-hospital mortality (OR 3.04, 95% CI 1.05-8.76). Use of more than 6 drugs independently predicted in-hospital mortality among geriatric patients (OR 3.04; 95% CI 1.05-8.76).
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