Morbid RANKIN score strongly predicts in-patient mortality within 90 days in older people in both acute and community care settings independently of FANGG (fracture, acquired neurological deficit or any geriatric giants) and acute illness markers (AIMs)

Phyo K Myint, Allan Clark, Edmund J Dunstan

Research output: Contribution to journalArticle

Abstract

Understanding the relative impact of factors that are associated with poor outcome of older people admitted either to an acute or a rehabilitation setting is essential to further our knowledge in provision of appropriate care. We conducted a prospective study to examine whether FANGG and AIMs are important prognostic indicators of mortality outcome in hospitalised older people when patients' morbid functional status is considered. Participants were two consecutive series of 200 patients admitted to care of the elderly wards in an acute teaching hospital and a community hospital in Birmingham, UK during April to August 2004 and the same months in 2005. The association with the outcome of mortality was examined in a univariate analysis, and then multiple logistic regression models. A total of 400 patients (men 116, 29.2%) were included in this study (mean age=85.3 years, range 64-104 years). There were 72 in-hospital deaths (18.0%). The prevalence of FANGG is low in this series; the majority (89.3%) had none or only one factor. The adjusted analysis showed that only age (p=0.05), gender (p=0.01) and morbid Rankin score (p<0.001) were predictive of outcome. The morbid Rankin score of 5 had over threefold higher likelihood of dying as in-patient (OR=3.31; 95% CI=1.48-7.40, p=0.003) independently of age, gender, site, FANGG, Rankin×AIMs interaction and AIMs. The morbid Rankin score strongly predicts the in-patient mortality over and above of age, gender, FANGG and AIMs in this patient population.

Original languageEnglish
Pages (from-to)439-442
Number of pages4
JournalArchives of Gerontology and Geriatrics
Volume54
Issue number3
DOIs
Publication statusPublished - 2 Jun 2011

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geriatrics
Geriatrics
deficit
illness
mortality
Mortality
community
gender
Logistic Models
dying
rehabilitation
logistics
Community Hospital
death
Teaching Hospitals
regression
Rehabilitation
Teaching
interaction
Prospective Studies

Keywords

  • acute disease
  • aged
  • aged, 80 and over
  • anoxia
  • consciousness disorders
  • female
  • fever
  • fractures, bone
  • hospitalization
  • humans
  • hypotension
  • intellectual disability
  • male
  • middle aged
  • mortality
  • prospective studies
  • residence characteristics
  • severity of illness index
  • urinary incontinence

Cite this

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title = "Morbid RANKIN score strongly predicts in-patient mortality within 90 days in older people in both acute and community care settings independently of FANGG (fracture, acquired neurological deficit or any geriatric giants) and acute illness markers (AIMs)",
abstract = "Understanding the relative impact of factors that are associated with poor outcome of older people admitted either to an acute or a rehabilitation setting is essential to further our knowledge in provision of appropriate care. We conducted a prospective study to examine whether FANGG and AIMs are important prognostic indicators of mortality outcome in hospitalised older people when patients' morbid functional status is considered. Participants were two consecutive series of 200 patients admitted to care of the elderly wards in an acute teaching hospital and a community hospital in Birmingham, UK during April to August 2004 and the same months in 2005. The association with the outcome of mortality was examined in a univariate analysis, and then multiple logistic regression models. A total of 400 patients (men 116, 29.2{\%}) were included in this study (mean age=85.3 years, range 64-104 years). There were 72 in-hospital deaths (18.0{\%}). The prevalence of FANGG is low in this series; the majority (89.3{\%}) had none or only one factor. The adjusted analysis showed that only age (p=0.05), gender (p=0.01) and morbid Rankin score (p<0.001) were predictive of outcome. The morbid Rankin score of 5 had over threefold higher likelihood of dying as in-patient (OR=3.31; 95{\%} CI=1.48-7.40, p=0.003) independently of age, gender, site, FANGG, Rankin×AIMs interaction and AIMs. The morbid Rankin score strongly predicts the in-patient mortality over and above of age, gender, FANGG and AIMs in this patient population.",
keywords = "acute disease, aged, aged, 80 and over, anoxia, consciousness disorders, female, fever, fractures, bone, hospitalization, humans, hypotension, intellectual disability, male, middle aged, mortality, prospective studies, residence characteristics, severity of illness index, urinary incontinence",
author = "Myint, {Phyo K} and Allan Clark and Dunstan, {Edmund J}",
note = "Copyright {\circledC} 2011 Elsevier Ireland Ltd. All rights reserved.",
year = "2011",
month = "6",
day = "2",
doi = "10.1016/j.archger.2011.04.026",
language = "English",
volume = "54",
pages = "439--442",
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TY - JOUR

T1 - Morbid RANKIN score strongly predicts in-patient mortality within 90 days in older people in both acute and community care settings independently of FANGG (fracture, acquired neurological deficit or any geriatric giants) and acute illness markers (AIMs)

AU - Myint, Phyo K

AU - Clark, Allan

AU - Dunstan, Edmund J

N1 - Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

PY - 2011/6/2

Y1 - 2011/6/2

N2 - Understanding the relative impact of factors that are associated with poor outcome of older people admitted either to an acute or a rehabilitation setting is essential to further our knowledge in provision of appropriate care. We conducted a prospective study to examine whether FANGG and AIMs are important prognostic indicators of mortality outcome in hospitalised older people when patients' morbid functional status is considered. Participants were two consecutive series of 200 patients admitted to care of the elderly wards in an acute teaching hospital and a community hospital in Birmingham, UK during April to August 2004 and the same months in 2005. The association with the outcome of mortality was examined in a univariate analysis, and then multiple logistic regression models. A total of 400 patients (men 116, 29.2%) were included in this study (mean age=85.3 years, range 64-104 years). There were 72 in-hospital deaths (18.0%). The prevalence of FANGG is low in this series; the majority (89.3%) had none or only one factor. The adjusted analysis showed that only age (p=0.05), gender (p=0.01) and morbid Rankin score (p<0.001) were predictive of outcome. The morbid Rankin score of 5 had over threefold higher likelihood of dying as in-patient (OR=3.31; 95% CI=1.48-7.40, p=0.003) independently of age, gender, site, FANGG, Rankin×AIMs interaction and AIMs. The morbid Rankin score strongly predicts the in-patient mortality over and above of age, gender, FANGG and AIMs in this patient population.

AB - Understanding the relative impact of factors that are associated with poor outcome of older people admitted either to an acute or a rehabilitation setting is essential to further our knowledge in provision of appropriate care. We conducted a prospective study to examine whether FANGG and AIMs are important prognostic indicators of mortality outcome in hospitalised older people when patients' morbid functional status is considered. Participants were two consecutive series of 200 patients admitted to care of the elderly wards in an acute teaching hospital and a community hospital in Birmingham, UK during April to August 2004 and the same months in 2005. The association with the outcome of mortality was examined in a univariate analysis, and then multiple logistic regression models. A total of 400 patients (men 116, 29.2%) were included in this study (mean age=85.3 years, range 64-104 years). There were 72 in-hospital deaths (18.0%). The prevalence of FANGG is low in this series; the majority (89.3%) had none or only one factor. The adjusted analysis showed that only age (p=0.05), gender (p=0.01) and morbid Rankin score (p<0.001) were predictive of outcome. The morbid Rankin score of 5 had over threefold higher likelihood of dying as in-patient (OR=3.31; 95% CI=1.48-7.40, p=0.003) independently of age, gender, site, FANGG, Rankin×AIMs interaction and AIMs. The morbid Rankin score strongly predicts the in-patient mortality over and above of age, gender, FANGG and AIMs in this patient population.

KW - acute disease

KW - aged

KW - aged, 80 and over

KW - anoxia

KW - consciousness disorders

KW - female

KW - fever

KW - fractures, bone

KW - hospitalization

KW - humans

KW - hypotension

KW - intellectual disability

KW - male

KW - middle aged

KW - mortality

KW - prospective studies

KW - residence characteristics

KW - severity of illness index

KW - urinary incontinence

U2 - 10.1016/j.archger.2011.04.026

DO - 10.1016/j.archger.2011.04.026

M3 - Article

VL - 54

SP - 439

EP - 442

JO - Archives of Gerontology and Geriatrics

JF - Archives of Gerontology and Geriatrics

SN - 0167-4943

IS - 3

ER -