Age, co-morbidity and poor mobility

no evidence of predicting in-patient death and acute hospital length of stay in the oldest old

Y Pai, C Butchart, C J Lunt, P Musonda, N Gautham, R L Soiza, J F Potter, P K Myint

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

BACKGROUND: The oldest old (aged over 90 years) are the fastest growing section of the UK population. Limited data exist regarding the effect of age, location, co-morbidity and physical performance status on outcome of acute illness in this age group.

METHODS: We performed a prospective study in people aged ≥ 90 years using hospital audit data in three hospitals in England and Scotland. We examined the characteristics of those admitted over three consecutive calendar months and calculated risk ratios of death and prolonged length of acute hospital stay (>7 days).

RESULTS: A total of 419 patients were included in this study (68% female, median age 93 years). There were similarities in presentation and diagnoses, but patients in Scotland (n = 164) were more likely to be admitted from sheltered housing or nursing homes than those in England (n = 255). Patients in England were significantly less likely to be able to mobilize < 10 m (41 vs. 34%, P < 0.001) but had lower prevalence of hypertension (40 vs. 55%, P = 0.02), ischaemic heart disease (30% vs. 45%, P = 0.02) and fewer prescribed medications (median 2 vs. 3, P < 0.001). Mortality was similar for the England and Scotland centres (P = 0.98). Previously recognized risk factors for death following hospital admission and length of stay e.g. older age, higher number of co-morbidities and poor mobility were not predictive in this study.

CONCLUSION: The 'oldest old' should not be considered as a homogenous group and findings from single-centre studies involving this age group may not be generalizable. We found no conclusive evidence that patient-related factors predict outcome in this age group in acute medical admission settings.

Original languageEnglish
Pages (from-to)671-679
Number of pages9
JournalQJM
Volume104
Issue number8
Early online date15 Mar 2011
DOIs
Publication statusPublished - Aug 2011

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England
Length of Stay
Scotland
Morbidity
Age Groups
Nursing Homes
Myocardial Ischemia
Odds Ratio
Prospective Studies
Hypertension
Mortality
Population

Keywords

  • age factors
  • aged, 80 and over
  • comorbidity
  • England
  • female
  • forecasting
  • hospital mortality
  • humans
  • length of stay
  • male
  • mobility limitation
  • prospective studies
  • Scotland

Cite this

Age, co-morbidity and poor mobility : no evidence of predicting in-patient death and acute hospital length of stay in the oldest old. / Pai, Y; Butchart, C; Lunt, C J; Musonda, P; Gautham, N; Soiza, R L; Potter, J F; Myint, P K.

In: QJM, Vol. 104, No. 8, 08.2011, p. 671-679.

Research output: Contribution to journalArticle

Pai, Y ; Butchart, C ; Lunt, C J ; Musonda, P ; Gautham, N ; Soiza, R L ; Potter, J F ; Myint, P K. / Age, co-morbidity and poor mobility : no evidence of predicting in-patient death and acute hospital length of stay in the oldest old. In: QJM. 2011 ; Vol. 104, No. 8. pp. 671-679.
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AU - Pai, Y

AU - Butchart, C

AU - Lunt, C J

AU - Musonda, P

AU - Gautham, N

AU - Soiza, R L

AU - Potter, J F

AU - Myint, P K

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N2 - BACKGROUND: The oldest old (aged over 90 years) are the fastest growing section of the UK population. Limited data exist regarding the effect of age, location, co-morbidity and physical performance status on outcome of acute illness in this age group.METHODS: We performed a prospective study in people aged ≥ 90 years using hospital audit data in three hospitals in England and Scotland. We examined the characteristics of those admitted over three consecutive calendar months and calculated risk ratios of death and prolonged length of acute hospital stay (>7 days).RESULTS: A total of 419 patients were included in this study (68% female, median age 93 years). There were similarities in presentation and diagnoses, but patients in Scotland (n = 164) were more likely to be admitted from sheltered housing or nursing homes than those in England (n = 255). Patients in England were significantly less likely to be able to mobilize < 10 m (41 vs. 34%, P < 0.001) but had lower prevalence of hypertension (40 vs. 55%, P = 0.02), ischaemic heart disease (30% vs. 45%, P = 0.02) and fewer prescribed medications (median 2 vs. 3, P < 0.001). Mortality was similar for the England and Scotland centres (P = 0.98). Previously recognized risk factors for death following hospital admission and length of stay e.g. older age, higher number of co-morbidities and poor mobility were not predictive in this study.CONCLUSION: The 'oldest old' should not be considered as a homogenous group and findings from single-centre studies involving this age group may not be generalizable. We found no conclusive evidence that patient-related factors predict outcome in this age group in acute medical admission settings.

AB - BACKGROUND: The oldest old (aged over 90 years) are the fastest growing section of the UK population. Limited data exist regarding the effect of age, location, co-morbidity and physical performance status on outcome of acute illness in this age group.METHODS: We performed a prospective study in people aged ≥ 90 years using hospital audit data in three hospitals in England and Scotland. We examined the characteristics of those admitted over three consecutive calendar months and calculated risk ratios of death and prolonged length of acute hospital stay (>7 days).RESULTS: A total of 419 patients were included in this study (68% female, median age 93 years). There were similarities in presentation and diagnoses, but patients in Scotland (n = 164) were more likely to be admitted from sheltered housing or nursing homes than those in England (n = 255). Patients in England were significantly less likely to be able to mobilize < 10 m (41 vs. 34%, P < 0.001) but had lower prevalence of hypertension (40 vs. 55%, P = 0.02), ischaemic heart disease (30% vs. 45%, P = 0.02) and fewer prescribed medications (median 2 vs. 3, P < 0.001). Mortality was similar for the England and Scotland centres (P = 0.98). Previously recognized risk factors for death following hospital admission and length of stay e.g. older age, higher number of co-morbidities and poor mobility were not predictive in this study.CONCLUSION: The 'oldest old' should not be considered as a homogenous group and findings from single-centre studies involving this age group may not be generalizable. We found no conclusive evidence that patient-related factors predict outcome in this age group in acute medical admission settings.

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KW - comorbidity

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KW - female

KW - forecasting

KW - hospital mortality

KW - humans

KW - length of stay

KW - male

KW - mobility limitation

KW - prospective studies

KW - Scotland

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JO - QJM

JF - QJM

SN - 1460-2725

IS - 8

ER -