Key result
Orthostatic hypotension was present in 52.3% of older medical inpatients at admission but was not significantly associated with adverse events during the hospital stay or at 6 months.
Why the study?
Does orthostatic hypotension predict adverse events in elderly medical inpatients?
Cohort (n=195)
No
Does orthostatic hypotension predict adverse events in elderly medical inpatients?
Orthostatic hypotension is highly prevalent in elderly inpatients but does not appear to predict short- or medium-term adverse events, questioning the value of routine screening.
No association with adverse events despite high prevalence; hypothesis-generating that routine screening may lack short-term value in elderly inpatients.
Background: Prevalence of orthostatic hypotension (OH) has been investigated in many studies, mainly on selected samples of subjects. We aimed to assess the prevalence of OH and its association with incidence of adverse events among older medical inpatients. Methods: OH was evaluated according to current guidelines at admission and at discharge among older medical inpatients admitted to a Geriatric acute ward of an university-teaching hospital. A comprehensive clinical (CIRS, Cumulative Illness Rating Scale), functional (ADL, Activities of Daily Living; IADL, Instrumental Activities of Daily Living Scale, TUG, Timed Up and Go) and cognitive (SPMSQ, Short Portable Mental Status Questionnaire) evaluation was performed. Length of stay-in and adverse events (death, institutionalization, falls, syncope, posttraumatic fractures, cardiovascular events) were evaluated at discharge and at 6 months. Results: Among 343 patients admitted, 195 (mean age 80.1 ± 7.2) were enrolled. Prevalence of OH at admission was 52.3%; patients with OH had higher systolic and diastolic blood pressure values (p=0.001 both) and lower heart rate (p=0.02) than patients without OH. Although several conditions were associated with presence of OH, only history of neurological and coronary artery disease were slightly independently associated with OH (p=0.03 and p=0.02, respectively). Prevalence of OH at discharge was 49%. OH was not significantly associated with any adverse event, nor during the hospital stay nor after discharge. Conclusion: OH is extremely common among elderly inpatients, but it was not associated with adverse events. Our results question the utility of routinely screening older medical inpatients for OH.
No takes yet. Share an insight, caveat, or question.
Michela Tibaldi Alessia Brescianini (2013) conducted a cohort in Older medical inpatients (n=195). Orthostatic hypotension vs. No orthostatic hypotension was evaluated on Adverse events (death, institutionalization, falls, syncope, posttraumatic fractures, cardiovascular events) at discharge and 6 months. Orthostatic hypotension was present in 52.3% of older medical inpatients at admission but was not significantly associated with adverse events during the hospital stay or at 6 months.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: