[Hospitalization in internal medicine of nonagenarians. Study of 150 cases]

Very elderly patients represent an increasing rate of hospitalized patients in internal medicine unit. Their admission and discharge modes, their morbidity and explaining factors for length of stay are still bad knowned. This prospective study concerns 150 patients stays, over 90, in an internal medicine and geriatric unit. Morbidity is mainly related with a high number of diagnoses (3.4 +/- 1.5). Most of them (2.8 +/- 1.3) are relevant for the hospitalization. The major categories of observed diseases are degenerative dementia, arrhythmias and adverse drug reactions. The main hospitalization mode is the non programmated one. We noted a high rate of death during hospitalization (17%). The main discharge mode is return home (88%). The length of stay among the survivals is significantly correlated (P < .001) with the number of diagnoses, the need for institutionalization and the sex. This pattern explains more than 20% of the variance of the length of stay. The data confirm the specificity of the medical care of very elderly patients. They also suggest that the french model of medicalization of the information system must be adapted to increase its pertinency among very elderly.