Predictors of 2-Year Post-Discharge Mortality in Hospitalized Older Patients
Background: Understanding prognostic factors for adverse health outcomes is clinically relevant for improving treatment decision-making processes, potentially leading to enhanced patient prognosis. This secondary analysis of a prospective observational study aimed to identify independent factors ass...
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| Format: | Article |
| Language: | English |
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MDPI AG
2024-02-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/13/5/1352 |
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| author | Christian Werner Melanie Sturm Patrick Heldmann Tim Fleiner Jürgen M. Bauer Klaus Hauer |
| author_facet | Christian Werner Melanie Sturm Patrick Heldmann Tim Fleiner Jürgen M. Bauer Klaus Hauer |
| author_sort | Christian Werner |
| collection | DOAJ |
| description | Background: Understanding prognostic factors for adverse health outcomes is clinically relevant for improving treatment decision-making processes, potentially leading to enhanced patient prognosis. This secondary analysis of a prospective observational study aimed to identify independent factors associated with 2-year post-discharge mortality in acutely hospitalized older patients. Methods: All-cause mortality and date of death of 115 patients (83.3 ± 6.3 years, females: <i>n</i> = 75, 65.2%) admitted to acute geriatric wards were determined two years after hospital discharge through telephone interviews. Potential prognostic factors measured at hospital admission included demographic and clinical characteristics, nutritional, cognitive, and psychological status, Fried frailty phenotype, functioning in activities of daily living, locomotor capacity, and 24 h in-hospital mobility and objectively measured physical activity (PA) behaviors. Results: The 2-year mortality rate was 36.7% (<i>n</i> = 41). Univariate and multivariate Cox proportional hazards regression models revealed that mean daily PA level (hazards ratio (HR) = 0.59, 95% confidence interval (CI) 0.90–1.00; <i>p</i> = 0.042), frailty (HR = 3.39, 95% CI 1.20–9.51; <i>p</i> = 0.020), and underweight, in contrast to overweight (HR = 3.10, 95% CI 1.07–9.01; <i>p</i> = 0.038), at hospital admission were independently predictive of post-discharge mortality. Conclusion: PA, frailty, and underweight at hospital admission should be considered when evaluating long-term survival prognosis, establishing risk profiles, and developing personalized care pathways in acute hospital care of older adults. |
| first_indexed | 2024-04-25T00:26:41Z |
| format | Article |
| id | doaj.art-7c99f8a1e2b34a5e9c4b7b37619d871e |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-04-25T00:26:41Z |
| publishDate | 2024-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-7c99f8a1e2b34a5e9c4b7b37619d871e2024-03-12T16:48:08ZengMDPI AGJournal of Clinical Medicine2077-03832024-02-01135135210.3390/jcm13051352Predictors of 2-Year Post-Discharge Mortality in Hospitalized Older PatientsChristian Werner0Melanie Sturm1Patrick Heldmann2Tim Fleiner3Jürgen M. Bauer4Klaus Hauer5Geriatric Centre, Heidelberg University Hospital, Agaplesion Bethanien Hospital Heidelberg, Rohrbacher Str. 149, 69216 Heidelberg, GermanyMedical Faculty Heidelberg, Heidelberg University, Im Neuenheimer Feld 672, 69120 Heidelberg, GermanyNetwork Aging Research (NAR), Heidelberg University, Bergheimer Str. 20, 69115 Heidelberg, GermanyInstitute for Geriatric Research, Ulm University Medical Centre, Zollernring 26, 89073 Ulm, GermanyGeriatric Centre, Heidelberg University Hospital, Agaplesion Bethanien Hospital Heidelberg, Rohrbacher Str. 149, 69216 Heidelberg, GermanyGeriatric Centre, Heidelberg University Hospital, Agaplesion Bethanien Hospital Heidelberg, Rohrbacher Str. 149, 69216 Heidelberg, GermanyBackground: Understanding prognostic factors for adverse health outcomes is clinically relevant for improving treatment decision-making processes, potentially leading to enhanced patient prognosis. This secondary analysis of a prospective observational study aimed to identify independent factors associated with 2-year post-discharge mortality in acutely hospitalized older patients. Methods: All-cause mortality and date of death of 115 patients (83.3 ± 6.3 years, females: <i>n</i> = 75, 65.2%) admitted to acute geriatric wards were determined two years after hospital discharge through telephone interviews. Potential prognostic factors measured at hospital admission included demographic and clinical characteristics, nutritional, cognitive, and psychological status, Fried frailty phenotype, functioning in activities of daily living, locomotor capacity, and 24 h in-hospital mobility and objectively measured physical activity (PA) behaviors. Results: The 2-year mortality rate was 36.7% (<i>n</i> = 41). Univariate and multivariate Cox proportional hazards regression models revealed that mean daily PA level (hazards ratio (HR) = 0.59, 95% confidence interval (CI) 0.90–1.00; <i>p</i> = 0.042), frailty (HR = 3.39, 95% CI 1.20–9.51; <i>p</i> = 0.020), and underweight, in contrast to overweight (HR = 3.10, 95% CI 1.07–9.01; <i>p</i> = 0.038), at hospital admission were independently predictive of post-discharge mortality. Conclusion: PA, frailty, and underweight at hospital admission should be considered when evaluating long-term survival prognosis, establishing risk profiles, and developing personalized care pathways in acute hospital care of older adults.https://www.mdpi.com/2077-0383/13/5/1352mortalityhospitalizationrisk factorsgeriatricsmobility |
| spellingShingle | Christian Werner Melanie Sturm Patrick Heldmann Tim Fleiner Jürgen M. Bauer Klaus Hauer Predictors of 2-Year Post-Discharge Mortality in Hospitalized Older Patients Journal of Clinical Medicine mortality hospitalization risk factors geriatrics mobility |
| title | Predictors of 2-Year Post-Discharge Mortality in Hospitalized Older Patients |
| title_full | Predictors of 2-Year Post-Discharge Mortality in Hospitalized Older Patients |
| title_fullStr | Predictors of 2-Year Post-Discharge Mortality in Hospitalized Older Patients |
| title_full_unstemmed | Predictors of 2-Year Post-Discharge Mortality in Hospitalized Older Patients |
| title_short | Predictors of 2-Year Post-Discharge Mortality in Hospitalized Older Patients |
| title_sort | predictors of 2 year post discharge mortality in hospitalized older patients |
| topic | mortality hospitalization risk factors geriatrics mobility |
| url | https://www.mdpi.com/2077-0383/13/5/1352 |
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