Resident characteristics associated with mortality in long-term care nursing homes: is there a gender difference?

To examine the gender-specific association between characteristics in established long-term care residents and 1-year risk of mortality.

A retrospective cohort study.

The Hebrew Rehabilitation Center for Aged, a 725-bed long-term care facility in Boston, Massachusetts. The 778 participants included 188 men (24%) and 590 women (76%).

Minimum Data Set (MDS) information, including items from the following sections: cognition, communication, psychosocial, functional, diseases, health conditions and medication use.

Survival curves were significantly different for men and women (log rank test, P = 0.004). Based on proportional hazards analyses, increased age, (RR(m)=1.07, RR(w)=1.05), functional impairment (RR(m)=1.07, RR(w)=1.04), and weight loss (RR(m)=2.03, RR(w)=2.24) were associated with increased mortality in men and women. Additionally, shortness of breath (RR = 2.87) and lower body mass index (RR = 2.25) were associated with higher mortality in men, and diabetes (RR = 2.42), pressure ulcers (RR = 1.99), anemia (RR = 1.98), congestive heart failure (RR = 1.87), and a recent fall (RR = 1.88) were associated with higher mortality in women.

Characteristics associated with 1-year mortality differ between men and women. These readily available data could be useful in making medical decisions and advance directives planning. Furthermore, these data may be beneficial in developing quality improvement initiatives and mortality prediction modeling.