Characteristics and determinants of survival in oldest old nursing home residents admitted to hospital with an acute illness compared to their younger counterparts

Katie Honney, Nicola J B Trepte, Richard A Parker, Jasmine Patel, Robert Mallinson, Sayed J Sultanzadeh, John F Potter, Phyo Kyaw Myint

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background and objectives
The clinical problems and needs of our oldest old (≥85 years) are often substantially different from those of younger patients, and are arguably different from younger elderly patients (age 65–84). With the increasing number of frail oldest olds residing in Nursing Homes (NH), we aim to identify differences in prognostic indicators and outcomes in this age group compared to younger NH residents.
Methods
We retrospectively identified all consecutive admissions from NHs to an Acute Medical Assessment Unit between January 2005 and December 2007. Admission prognostic indicators and outcomes at follow-up were compared between younger (<85) and older (≥85) age groups. Using multiple regression methods controlling for potential confounders, we compared in-hospital mortality and long-term survival after discharge between the groups.
Results
Three hundred and sixteen patients (mean age 84.3, SD 8.34 years) were included (68 % females). Admission characteristics were mostly similar between age groups. In-hospital mortality rates were not significantly different between groups, even after adjusting for possible confounders. Oldest old patients had a significantly greater hazard of dying after discharge (HR 1.37; 1.03–1.83) compared to the younger group after removing explanatory variables with more than 5 % missing data.
Conclusion
Whilst the admission characteristics are similar between younger and older patients from NHs, there is evidence to suggest worse long-term survival prospects for oldest old patients.
Original languageEnglish
Pages (from-to)153-160
Number of pages8
JournalAging Clinical and Experimental Research
Volume26
Issue number2
DOIs
Publication statusPublished - Apr 2014

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Nursing Homes
Survival
Age Groups
Hospital Mortality
Mortality

Keywords

  • oldest old
  • nursing home
  • mortality
  • survival

Cite this

Characteristics and determinants of survival in oldest old nursing home residents admitted to hospital with an acute illness compared to their younger counterparts. / Honney, Katie; Trepte, Nicola J B; Parker, Richard A; Patel, Jasmine; Mallinson, Robert; Sultanzadeh, Sayed J; Potter, John F; Myint, Phyo Kyaw.

In: Aging Clinical and Experimental Research, Vol. 26, No. 2, 04.2014, p. 153-160.

Research output: Contribution to journalArticle

Honney, Katie ; Trepte, Nicola J B ; Parker, Richard A ; Patel, Jasmine ; Mallinson, Robert ; Sultanzadeh, Sayed J ; Potter, John F ; Myint, Phyo Kyaw. / Characteristics and determinants of survival in oldest old nursing home residents admitted to hospital with an acute illness compared to their younger counterparts. In: Aging Clinical and Experimental Research. 2014 ; Vol. 26, No. 2. pp. 153-160.
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abstract = "Background and objectivesThe clinical problems and needs of our oldest old (≥85 years) are often substantially different from those of younger patients, and are arguably different from younger elderly patients (age 65–84). With the increasing number of frail oldest olds residing in Nursing Homes (NH), we aim to identify differences in prognostic indicators and outcomes in this age group compared to younger NH residents.MethodsWe retrospectively identified all consecutive admissions from NHs to an Acute Medical Assessment Unit between January 2005 and December 2007. Admission prognostic indicators and outcomes at follow-up were compared between younger (<85) and older (≥85) age groups. Using multiple regression methods controlling for potential confounders, we compared in-hospital mortality and long-term survival after discharge between the groups.ResultsThree hundred and sixteen patients (mean age 84.3, SD 8.34 years) were included (68 {\%} females). Admission characteristics were mostly similar between age groups. In-hospital mortality rates were not significantly different between groups, even after adjusting for possible confounders. Oldest old patients had a significantly greater hazard of dying after discharge (HR 1.37; 1.03–1.83) compared to the younger group after removing explanatory variables with more than 5 {\%} missing data.ConclusionWhilst the admission characteristics are similar between younger and older patients from NHs, there is evidence to suggest worse long-term survival prospects for oldest old patients.",
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AU - Mallinson, Robert

AU - Sultanzadeh, Sayed J

AU - Potter, John F

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N2 - Background and objectivesThe clinical problems and needs of our oldest old (≥85 years) are often substantially different from those of younger patients, and are arguably different from younger elderly patients (age 65–84). With the increasing number of frail oldest olds residing in Nursing Homes (NH), we aim to identify differences in prognostic indicators and outcomes in this age group compared to younger NH residents.MethodsWe retrospectively identified all consecutive admissions from NHs to an Acute Medical Assessment Unit between January 2005 and December 2007. Admission prognostic indicators and outcomes at follow-up were compared between younger (<85) and older (≥85) age groups. Using multiple regression methods controlling for potential confounders, we compared in-hospital mortality and long-term survival after discharge between the groups.ResultsThree hundred and sixteen patients (mean age 84.3, SD 8.34 years) were included (68 % females). Admission characteristics were mostly similar between age groups. In-hospital mortality rates were not significantly different between groups, even after adjusting for possible confounders. Oldest old patients had a significantly greater hazard of dying after discharge (HR 1.37; 1.03–1.83) compared to the younger group after removing explanatory variables with more than 5 % missing data.ConclusionWhilst the admission characteristics are similar between younger and older patients from NHs, there is evidence to suggest worse long-term survival prospects for oldest old patients.

AB - Background and objectivesThe clinical problems and needs of our oldest old (≥85 years) are often substantially different from those of younger patients, and are arguably different from younger elderly patients (age 65–84). With the increasing number of frail oldest olds residing in Nursing Homes (NH), we aim to identify differences in prognostic indicators and outcomes in this age group compared to younger NH residents.MethodsWe retrospectively identified all consecutive admissions from NHs to an Acute Medical Assessment Unit between January 2005 and December 2007. Admission prognostic indicators and outcomes at follow-up were compared between younger (<85) and older (≥85) age groups. Using multiple regression methods controlling for potential confounders, we compared in-hospital mortality and long-term survival after discharge between the groups.ResultsThree hundred and sixteen patients (mean age 84.3, SD 8.34 years) were included (68 % females). Admission characteristics were mostly similar between age groups. In-hospital mortality rates were not significantly different between groups, even after adjusting for possible confounders. Oldest old patients had a significantly greater hazard of dying after discharge (HR 1.37; 1.03–1.83) compared to the younger group after removing explanatory variables with more than 5 % missing data.ConclusionWhilst the admission characteristics are similar between younger and older patients from NHs, there is evidence to suggest worse long-term survival prospects for oldest old patients.

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