Vital signs as determinants of immediate and longer term mortality outcome of patients admitted from nursing homes

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

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

BACKGROUND AND AIMS: Hospital admissions from Nursing Homes (NHs) are associated with high mortality. Identifying people with a poor prognosis admitted from NHs is essential to inform appropriate clinical decision making.

METHODS: We identified all consecutive admissions from NHs (all ages) to an Acute Medical Assessment Unit (AMU) of a large District General Hospital in UK with a catchment population of ~360,000 between January 2005-December 2007 and reviewed their outcome to end of March 2009 (median follow-up=133 days). The relation between admission vital signs (systolic blood pressure, pulse rate, respiratory rate, body temperature and Glasgow Coma Scale-GCS) and outcomes including in-patient mortality, hospital length of stay and mortality at followup were examined using logistic and Cox regression models.

RESULTS: The cohort consisted of 316 patients (32% male), mean age at admission was 83.8 years (SD 8.36 yrs; range=49-99 yrs). Sixty-seven (21%) had at least two admissions during the study period; the maximum number of readmissions was five. We found strong evidence that lower systolic blood pressure and higher respiratory rate at the time of admission were associated with increased probability of in-patient death and reduced survival time but not with length of stay. Older age and lower admission GCS were additionally associated with overall poor prognosis.

CONCLUSION: Simple and readily available hospital admission parameters predict not only the in-patient mortality but also longer term outcome for NH residents who require acute hospital admission. Further studies are required to examine whether opportunities exist to intervene and improve outcome in this patient population.

Original languageEnglish
Pages (from-to)309-315
Number of pages7
JournalAging Clinical and Experimental Research
Volume23
Issue number4
DOIs
Publication statusPublished - Aug 2011

Fingerprint

Vital Signs
Nursing Homes
Mortality
Blood Pressure
Length of Stay
Respiratory Rate
Glasgow Coma Scale
District Hospitals
Hospital Mortality
Body Temperature
Proportional Hazards Models
General Hospitals
Population
Heart Rate
Logistic Models
Survival

Keywords

  • aged
  • aged, 80 and over
  • female
  • Great Britain
  • hospital mortality
  • hospitalization
  • humans
  • Kaplan-Meier estimate
  • length of stay
  • male
  • middle aged
  • nursing homes
  • prognosis
  • prospective studies
  • retrospective studies
  • vital signs

Cite this

Vital signs as determinants of immediate and longer term mortality outcome of patients admitted from nursing homes. / Myint, Phyo K; Trepte, Nicola J B; Parker, Richard A; Sultanzadeh, Sayed J; Patel, Jasmine; Mallinson, Robert; Potter, John F.

In: Aging Clinical and Experimental Research, Vol. 23, No. 4, 08.2011, p. 309-315.

Research output: Contribution to journalArticle

Myint, Phyo K ; Trepte, Nicola J B ; Parker, Richard A ; Sultanzadeh, Sayed J ; Patel, Jasmine ; Mallinson, Robert ; Potter, John F. / Vital signs as determinants of immediate and longer term mortality outcome of patients admitted from nursing homes. In: Aging Clinical and Experimental Research. 2011 ; Vol. 23, No. 4. pp. 309-315.
@article{073a6d26ce63492aba4f610dd8498d49,
title = "Vital signs as determinants of immediate and longer term mortality outcome of patients admitted from nursing homes",
abstract = "BACKGROUND AND AIMS: Hospital admissions from Nursing Homes (NHs) are associated with high mortality. Identifying people with a poor prognosis admitted from NHs is essential to inform appropriate clinical decision making.METHODS: We identified all consecutive admissions from NHs (all ages) to an Acute Medical Assessment Unit (AMU) of a large District General Hospital in UK with a catchment population of ~360,000 between January 2005-December 2007 and reviewed their outcome to end of March 2009 (median follow-up=133 days). The relation between admission vital signs (systolic blood pressure, pulse rate, respiratory rate, body temperature and Glasgow Coma Scale-GCS) and outcomes including in-patient mortality, hospital length of stay and mortality at followup were examined using logistic and Cox regression models.RESULTS: The cohort consisted of 316 patients (32{\%} male), mean age at admission was 83.8 years (SD 8.36 yrs; range=49-99 yrs). Sixty-seven (21{\%}) had at least two admissions during the study period; the maximum number of readmissions was five. We found strong evidence that lower systolic blood pressure and higher respiratory rate at the time of admission were associated with increased probability of in-patient death and reduced survival time but not with length of stay. Older age and lower admission GCS were additionally associated with overall poor prognosis.CONCLUSION: Simple and readily available hospital admission parameters predict not only the in-patient mortality but also longer term outcome for NH residents who require acute hospital admission. Further studies are required to examine whether opportunities exist to intervene and improve outcome in this patient population.",
keywords = "aged, aged, 80 and over, female, Great Britain, hospital mortality, hospitalization, humans, Kaplan-Meier estimate, length of stay, male, middle aged, nursing homes, prognosis, prospective studies, retrospective studies, vital signs",
author = "Myint, {Phyo K} and Trepte, {Nicola J B} and Parker, {Richard A} and Sultanzadeh, {Sayed J} and Jasmine Patel and Robert Mallinson and Potter, {John F}",
year = "2011",
month = "8",
doi = "10.1007/BF03337756",
language = "English",
volume = "23",
pages = "309--315",
journal = "Aging Clinical and Experimental Research",
issn = "1594-0667",
publisher = "Springer Verlag",
number = "4",

}

TY - JOUR

T1 - Vital signs as determinants of immediate and longer term mortality outcome of patients admitted from nursing homes

AU - Myint, Phyo K

AU - Trepte, Nicola J B

AU - Parker, Richard A

AU - Sultanzadeh, Sayed J

AU - Patel, Jasmine

AU - Mallinson, Robert

AU - Potter, John F

PY - 2011/8

Y1 - 2011/8

N2 - BACKGROUND AND AIMS: Hospital admissions from Nursing Homes (NHs) are associated with high mortality. Identifying people with a poor prognosis admitted from NHs is essential to inform appropriate clinical decision making.METHODS: We identified all consecutive admissions from NHs (all ages) to an Acute Medical Assessment Unit (AMU) of a large District General Hospital in UK with a catchment population of ~360,000 between January 2005-December 2007 and reviewed their outcome to end of March 2009 (median follow-up=133 days). The relation between admission vital signs (systolic blood pressure, pulse rate, respiratory rate, body temperature and Glasgow Coma Scale-GCS) and outcomes including in-patient mortality, hospital length of stay and mortality at followup were examined using logistic and Cox regression models.RESULTS: The cohort consisted of 316 patients (32% male), mean age at admission was 83.8 years (SD 8.36 yrs; range=49-99 yrs). Sixty-seven (21%) had at least two admissions during the study period; the maximum number of readmissions was five. We found strong evidence that lower systolic blood pressure and higher respiratory rate at the time of admission were associated with increased probability of in-patient death and reduced survival time but not with length of stay. Older age and lower admission GCS were additionally associated with overall poor prognosis.CONCLUSION: Simple and readily available hospital admission parameters predict not only the in-patient mortality but also longer term outcome for NH residents who require acute hospital admission. Further studies are required to examine whether opportunities exist to intervene and improve outcome in this patient population.

AB - BACKGROUND AND AIMS: Hospital admissions from Nursing Homes (NHs) are associated with high mortality. Identifying people with a poor prognosis admitted from NHs is essential to inform appropriate clinical decision making.METHODS: We identified all consecutive admissions from NHs (all ages) to an Acute Medical Assessment Unit (AMU) of a large District General Hospital in UK with a catchment population of ~360,000 between January 2005-December 2007 and reviewed their outcome to end of March 2009 (median follow-up=133 days). The relation between admission vital signs (systolic blood pressure, pulse rate, respiratory rate, body temperature and Glasgow Coma Scale-GCS) and outcomes including in-patient mortality, hospital length of stay and mortality at followup were examined using logistic and Cox regression models.RESULTS: The cohort consisted of 316 patients (32% male), mean age at admission was 83.8 years (SD 8.36 yrs; range=49-99 yrs). Sixty-seven (21%) had at least two admissions during the study period; the maximum number of readmissions was five. We found strong evidence that lower systolic blood pressure and higher respiratory rate at the time of admission were associated with increased probability of in-patient death and reduced survival time but not with length of stay. Older age and lower admission GCS were additionally associated with overall poor prognosis.CONCLUSION: Simple and readily available hospital admission parameters predict not only the in-patient mortality but also longer term outcome for NH residents who require acute hospital admission. Further studies are required to examine whether opportunities exist to intervene and improve outcome in this patient population.

KW - aged

KW - aged, 80 and over

KW - female

KW - Great Britain

KW - hospital mortality

KW - hospitalization

KW - humans

KW - Kaplan-Meier estimate

KW - length of stay

KW - male

KW - middle aged

KW - nursing homes

KW - prognosis

KW - prospective studies

KW - retrospective studies

KW - vital signs

U2 - 10.1007/BF03337756

DO - 10.1007/BF03337756

M3 - Article

VL - 23

SP - 309

EP - 315

JO - Aging Clinical and Experimental Research

JF - Aging Clinical and Experimental Research

SN - 1594-0667

IS - 4

ER -