We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Short- and long-term outcomes of older patients in intermediate care units.
- Authors
Torres, Olga; Francia, Esther; Longobardi, Vanesa; Gich, Ignasi; Benito, Salvador; Ruiz, Domingo; Torres, Olga H
- Abstract
<bold>Objective: </bold>To evaluate short- and long-term outcomes of elderly patients (>or=65 years) treated at an intermediate care unit (IMCU) and to identify outcome predictors.<bold>Design and Setting: </bold>Prospective observational study in the IMCU of a university teaching hospital.<bold>Participants: </bold>We studied 412 patients over 8 months, classified into three groups: under 65years (control group, n=158), 65-80 (n=186), and >80 (n=68).<bold>Measurements: </bold>At admission: APACHE II, TISS-28 first day, Charlson Index, diagnosis, and prior Barthel Index.<bold>Outcome Measures: </bold>in-hospital mortality, length of stay, discharge destination, and 2-year mortality and readmissions. Data analysis included multivariate logistic regression and receiver operating characteristics area under the curve (ROC AUC).<bold>Results: </bold>No statistically significant differences between groups were observed in hospital mortality (14.1%), discharge to a long-term facility (2.7%), or 2-year readmissions (1.2+/-2.1). However, hospital stay was longer in patients aged 65-80years (14 vs.10 days) and 2-year mortality was higher in those 65 or over (34% vs.10.6%). In the overall series in-hospital mortality was predicted by APACHE II, first-day TISS-28, and diagnosis (ROC AUC 0.81), and 2-year mortality by Charlson Index and age (ROC AUC 0.77). In the elderly patients 2-year mortality was predicted by Charlson and Barthel indices (ROC AUC 0.70).<bold>Conclusions: </bold>Illness severity and therapeutic intervention at admission to IMCU were predictors of short-term mortality, whereas the strongest predictor of long-term mortality was comorbidity. Our results suggest that comprehensive assessment of elderly patients at admission to IMCUs may improve outcome prediction.
- Subjects
SPAIN; CRITICAL care medicine; HEALTH outcome assessment; OLDER people; PATIENTS; TEACHING hospitals; APACHE (Disease classification system); CHI-squared test; LENGTH of stay in hospitals; LONGITUDINAL method; NURSING care facilities; SURVIVAL analysis (Biometry); LOGISTIC regression analysis; SEVERITY of illness index; RECEIVER operating characteristic curves; PATIENT readmissions; HOSPITAL mortality; BARTHEL Index
- Publication
Intensive Care Medicine, 2006, Vol 32, Issue 7, p1052
- ISSN
0342-4642
- Publication type
journal article
- DOI
10.1007/s00134-006-0170-1