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[Factors predicting a prolonged hospital stay in elderly patients]
1Dirigente Medico di I livello nell'Unità Operativa e Direzione Universitaria Geriatria, Università degli Studi di Torino, Azienda Ospedaliera S. Giovanni Battista, Turin, Italy.
Background:
Aim of our prospective study was to evaluate risk factors for prolonged hospitalization in elderly patients.
Methods:
The study sample included 1054 patients admitted to University Department of Geriatric Medicine in Turin, Italy. We analysed: demographic variables (age, sex, marital status, economic status and living condition), affective status (GDS), cognitive status (SPMSQ), functional status (ADL-IADL), medical dependence (DMI), medical diagnosis, systolic and diastolic blood pressure, some haematological parameters (haemoglobin, creatinine, albumin, sodium, potassium).
Results:
Average length of stays was 18+/-20.6 days; 178 patients died during hospitalization and their length of stay significantly longer (21.8+/-25.59) than survivors (17.4+/-19.3). We find that DMI dependence, impaired IADL and ADL score were associated with longer hospital stays. Medical diagnosis related to a prolonged hospitalization were: neoplasm, chronic bronchitis, hip fracture and peripheral arterial disease (PAD) with critical ischemia. Longer hospitalisation was associated also with high level of creatinine and low level of albumin and sodium. Indipendent predictors variables of prolonged hospital stay were: ADL impairment, pressure sores, hip fractures, PAD with critical ischemia, low sodium value.
Conclusions:
Multidimensional assessment among hospitalized elderly allows to identify risk factors for prolonged hospital stay.