Unveiling the Burden of Interactions Among Clinical Risk Factors for 1-Year Mortality in Hospitalized Older Patients
Background: Hospitalized older patients are particularly exposed to adverse health outcomes.Objective: In this study, we aimed at investigating the prognostic interactions between disability in basic activities of daily living (BADL), cognitive impairment, low handgrip strength, anticholinergic cogn...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2021-11-01
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| Series: | Frontiers in Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2021.771115/full |
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| author | Fabrizia Lattanzio Valentina Corigliano Luca Soraci Alessia Fumagalli Graziano Onder Stefano Volpato Stefano Volpato Antonio Cherubini Carmelinda Ruggiero Annalisa Cozza Francesco Guarasci Andrea Corsonello Andrea Corsonello |
| author_facet | Fabrizia Lattanzio Valentina Corigliano Luca Soraci Alessia Fumagalli Graziano Onder Stefano Volpato Stefano Volpato Antonio Cherubini Carmelinda Ruggiero Annalisa Cozza Francesco Guarasci Andrea Corsonello Andrea Corsonello |
| author_sort | Fabrizia Lattanzio |
| collection | DOAJ |
| description | Background: Hospitalized older patients are particularly exposed to adverse health outcomes.Objective: In this study, we aimed at investigating the prognostic interactions between disability in basic activities of daily living (BADL), cognitive impairment, low handgrip strength, anticholinergic cognitive burden (ACB), and depression on 1-year mortality.Setting and Subjects: Our series consisted of 503 older patients discharged from acute care hospitals.Methods: Disability in at least one BADL, ACB, depression, cognitive impairment, and low handgrip strength was considered in the analysis. One-year mortality was investigated by Cox regression analysis and prognostic interactions among study variables were assessed by survival tree analysis.Results: Basic activities of daily living disability, ACB, cognitive impairment, and low handgrip strength were significantly associated with 1-year mortality. Survival tree analysis showed that patients with BADL disability and high ACB carried the highest risk of poor survival [hazard ratio (HR): 16.48 (2.63–74.72)], followed by patients with BADL disability and low ACB (HR: 8.43, 95% CI: 1.85–38.87). Patients with cognitive impairment and no BADL disability were characterized by a lower but still significant risk of mortality (HR: 6.61, 95% CI: 1.51–28.97) and those with high ACB scores and good cognitive and functional performance (HR: 5.28, 95% CI: 1.13–24.55).Conclusion: Basic activities of daily living dependency, cognitive impairment, and ACB score were the three main predictors of 1-year mortality among patients discharged from acute care hospitals; the interaction between BADL dependency and ACB score wasfound to significantly affect survival. Early identification of such high-risk patients may help tailor targeted interventions to counteract their detrimental effects on prognosis. |
| first_indexed | 2024-12-14T07:40:40Z |
| format | Article |
| id | doaj.art-b434bc810c194de1a5e1d64779aff24c |
| institution | Directory Open Access Journal |
| issn | 2296-858X |
| language | English |
| last_indexed | 2024-12-14T07:40:40Z |
| publishDate | 2021-11-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Medicine |
| spelling | doaj.art-b434bc810c194de1a5e1d64779aff24c2022-12-21T23:11:03ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2021-11-01810.3389/fmed.2021.771115771115Unveiling the Burden of Interactions Among Clinical Risk Factors for 1-Year Mortality in Hospitalized Older PatientsFabrizia Lattanzio0Valentina Corigliano1Luca Soraci2Alessia Fumagalli3Graziano Onder4Stefano Volpato5Stefano Volpato6Antonio Cherubini7Carmelinda Ruggiero8Annalisa Cozza9Francesco Guarasci10Andrea Corsonello11Andrea Corsonello12Scientific Direction, Istituto Di Ricovero e Cura a Carattere Scientifico Italian National Research Centers on Aging, Ancona, ItalyDepartment of Clinical and Experimental Medicine, University of Messina, Messina, ItalyUnit of Geriatric Medicine, Istituto Di Ricovero e Cura a Carattere Scientifico Italian National Research Centers on Aging, Cosenza, ItalyRespiratory Unit, Istituto Di Ricovero e Cura a Carattere Scientifico Italian National Research Centers on Aging, Casatenovo, ItalyDepartment of Cardiovascular, Endocrine-Metabolic Diseases and Aging, IstitutoSuperiore di Sanitá, Rome, ItalyDepartment of Medical Sciences, University of Ferrara, Ferrara, ItalyCenter for Clinical Epidemiology, School of Medicine, University of Ferrara, Ferrara, ItalyGeriatria, Accettazionegeriatrica e Centro di Ricerca per l'Invecchiamento, Istituto Di Ricovero e Cura a Carattere Scientifico Italian National Research Centers on Aging, Ancona, ItalyOrthogeriatric and Geriatric Units, Gerontology and Geriatric Sections, Department of Medicine and Surgery, University of Perugia, Perugia, Italy0Unit of Geriatric Pharmacoepidemiology and Biostatistics, Istituto Di Ricovero e Cura a Carattere Scientifico Italian National Research Centers on Aging, Ancona, Italy0Unit of Geriatric Pharmacoepidemiology and Biostatistics, Istituto Di Ricovero e Cura a Carattere Scientifico Italian National Research Centers on Aging, Ancona, ItalyUnit of Geriatric Medicine, Istituto Di Ricovero e Cura a Carattere Scientifico Italian National Research Centers on Aging, Cosenza, Italy0Unit of Geriatric Pharmacoepidemiology and Biostatistics, Istituto Di Ricovero e Cura a Carattere Scientifico Italian National Research Centers on Aging, Ancona, ItalyBackground: Hospitalized older patients are particularly exposed to adverse health outcomes.Objective: In this study, we aimed at investigating the prognostic interactions between disability in basic activities of daily living (BADL), cognitive impairment, low handgrip strength, anticholinergic cognitive burden (ACB), and depression on 1-year mortality.Setting and Subjects: Our series consisted of 503 older patients discharged from acute care hospitals.Methods: Disability in at least one BADL, ACB, depression, cognitive impairment, and low handgrip strength was considered in the analysis. One-year mortality was investigated by Cox regression analysis and prognostic interactions among study variables were assessed by survival tree analysis.Results: Basic activities of daily living disability, ACB, cognitive impairment, and low handgrip strength were significantly associated with 1-year mortality. Survival tree analysis showed that patients with BADL disability and high ACB carried the highest risk of poor survival [hazard ratio (HR): 16.48 (2.63–74.72)], followed by patients with BADL disability and low ACB (HR: 8.43, 95% CI: 1.85–38.87). Patients with cognitive impairment and no BADL disability were characterized by a lower but still significant risk of mortality (HR: 6.61, 95% CI: 1.51–28.97) and those with high ACB scores and good cognitive and functional performance (HR: 5.28, 95% CI: 1.13–24.55).Conclusion: Basic activities of daily living dependency, cognitive impairment, and ACB score were the three main predictors of 1-year mortality among patients discharged from acute care hospitals; the interaction between BADL dependency and ACB score wasfound to significantly affect survival. Early identification of such high-risk patients may help tailor targeted interventions to counteract their detrimental effects on prognosis.https://www.frontiersin.org/articles/10.3389/fmed.2021.771115/fullhospitalized older patientsanticholinergic burdenfunctional impairmentcognitive impairmenthandgripdepression |
| spellingShingle | Fabrizia Lattanzio Valentina Corigliano Luca Soraci Alessia Fumagalli Graziano Onder Stefano Volpato Stefano Volpato Antonio Cherubini Carmelinda Ruggiero Annalisa Cozza Francesco Guarasci Andrea Corsonello Andrea Corsonello Unveiling the Burden of Interactions Among Clinical Risk Factors for 1-Year Mortality in Hospitalized Older Patients Frontiers in Medicine hospitalized older patients anticholinergic burden functional impairment cognitive impairment handgrip depression |
| title | Unveiling the Burden of Interactions Among Clinical Risk Factors for 1-Year Mortality in Hospitalized Older Patients |
| title_full | Unveiling the Burden of Interactions Among Clinical Risk Factors for 1-Year Mortality in Hospitalized Older Patients |
| title_fullStr | Unveiling the Burden of Interactions Among Clinical Risk Factors for 1-Year Mortality in Hospitalized Older Patients |
| title_full_unstemmed | Unveiling the Burden of Interactions Among Clinical Risk Factors for 1-Year Mortality in Hospitalized Older Patients |
| title_short | Unveiling the Burden of Interactions Among Clinical Risk Factors for 1-Year Mortality in Hospitalized Older Patients |
| title_sort | unveiling the burden of interactions among clinical risk factors for 1 year mortality in hospitalized older patients |
| topic | hospitalized older patients anticholinergic burden functional impairment cognitive impairment handgrip depression |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2021.771115/full |
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