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  • Title: Time-dependent prognostic factors of 6-month mortality in frail elderly patients admitted to post-acute care.
    Author: Espaulella J, Arnau A, Cubí D, Amblàs J, Yánez A.
    Journal: Age Ageing; 2007 Jul; 36(4):407-13. PubMed ID: 17395620.
    Abstract:
    OBJECTIVE: To determine the association between functional and nutritional changes caused by an acute illness requiring hospitalisation and 6-month mortality. DESIGN: Hospital-based prospective longitudinal cohort study. SETTING: Acute care centre (Hospital General de Vic, Barcelona Province, Spain). Post-acute care centre (Hospital de la Santa Creu de Vic, Barcelona Province, Spain). SUBJECTS: Hundred sixty five patients aged 75 years and older, hospitalised for an acute event. METHODS: Functional status (Barthel and Lawton Indices), cognitive status (Short Portable Mental Status Questionnaire), nutritional status (Mini Nutritional Assessment, albumin, cholesterol), depressive symptoms (Geriatric Depression Scale), co-morbidity (Charlson Index) and self-rated health status were collected upon admission to the post-acute care centre. Functional and nutritional status were assessed 1, 3 and 6 months after admission by a trained staff of geriatricians. Six-month mortality was the main outcome variable. Survival analysis was performed with functional and nutritional status as time-dependent variables. RESULTS: The mean age of the cohort was 83.3 years (SD 5.1) and 68.5% were female. Six-month mortality was 29.1% (95% CI: 22.2-36.7). The variables associated with mortality in bivariate analysis were: gender, Barthel Index (2 weeks before admission), Lawton Index (2 weeks before admission), Charlson Index, Barthel Index (time-dependent), Mini Nutritional Assessment (MNA) (time-dependent) and cognitive status. The variables associated with mortality in multivariate analysis were: gender, Barthel Index (2 weeks before admission), Charlson Index and MNA (time-dependent). CONCLUSIONS: Functional and nutritional changes due to an acute illness have a statistical and clinical prognostic value and should be assessed along with other well-known relevant prognostic factors.
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