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Assessment of Dependence in Activities of Daily Living Among Older Patients in an Acute Care Unit
Published on: September 30, 2020
The impact of COVID-19 pandemic on the geriatric inpatient unit
Tugce Emiroglu Gedik1, Damla Unal1, Veysel Suzan1
1Division of Geriatrics, Department of Internal Medicine, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey.
Objective:
We aimed to determine the effects of the pandemic on the inpatients in the geriatric unit by comparing the demographic and clinical characteristics, reasons for hospitalization, morbidity, and mortality of the patients before and during the pandemic.
Methods:
The population of this retrospective, cross-sectional study consisted of inpatients in the geriatric unit for two years (11 March 2019-10 March 2021). The patients were separated into two groups according to the hospitalization time as pre-COVID-19 and COVID-19 period. Hospitalization types, reasons for hospitalization, length of stay, demographic data, chronic diseases, drugs, developed morbidities, discharge, and 1-year mortality status of the patients were recorded.
Results:
Three hundred and fifty patients were included in our study. The mean age was 80.4 ± 8.02. It was observed that the number of hospitalized patients decreased by ∼50% in the COVID-19 period. However, there was a significant decrease in hospitalization due to the control of chronic diseases during the COVID-19 period (p = .008). The number of inpatients from the emergency department was found to be higher during the COVID-19 period (p < .001). Regarding the presence of geriatric syndromes, polypharmacy (p = .011) and delirium (p = .035) were found to be significantly less in the pre-COVID-19 period. The percentage of malnutrition was also detected as lower, but it was not statistically significant. In terms of 1-year mortality, although not statistically significant, the all-cause mortality rate was higher during the COVID-19 period (p = .08).
Conclusions:
Pandemic has greatly affected the geriatric unit. The prognosis of the patients has worsened and mortality rates have increased. Physiological and psychological deterioration caused by quarantine measures, worsening chronic diseases, and immunosenescence affected the prognosis of geriatric patients. This adds to the previous literature by proving the fact that older individuals are the most vulnerable group in the pandemic.
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