[Morbidity and mortality among the hospitalized aged. Identification of prognostic factors]

Advancing age is an independent predictor of increased mortality. Our purpose was to study morbimortality in very elderly inpatients (Eighty years and older) and to recognize risk factors of hospital-associated mortality.

All consecutive eighty years and older patients admitted at the Hospital over a one year period were studied. On the first day we collected: symptoms, signs, presumed diagnostic, arterial blood pressure, pulse and respiratory frequency, level of alertness, hydration status, level of hemoglobin, plasma urea, creatinine, Na, K, albumin and arterial blood gases. We also collected end-stay diagnostic and outcome.

A total of 131 patients were included with a mean age 83.92 +/- 3.53 (+/-SD). The most frequent diseases were heart failure, chronic obstructive pulmonary disease, stroke and pneumonia. While inpatient 21 (16%) died (Mean age 85.42 +/- 4.46, p < 0.05). Patients whose admission symptoms were arthralgia, myalgia, diarrhea, anemia, syncope and hemiparesis (p < 0.05) and whose presumed diagnostic were rheumatic disease (p < 0.01) and nephrourological disorder (p < 0.001) had lower mortality. A presumed diagnostic on admission of pneumonia had higher mortality (p < 0.05). Risk factors associated with higher mortality were dehydrations signs, decreased alertness status, hypoalbuminemia and elevated plasma urea (p < 0.001). When analysed altogether in order to predict Hospital-associated death had sensitivity 80%, specificity 87%, truepredictive rate 44% and false-predictive rate 97%.

Morbidity of the very elderly patients is caused by chronic disorders. Pneumonia is a leading cause of death mainly in patients with decreased level of alertness, dehydration, hypoalbuminemia and elevated plasma urea.