Hospital Mortality Among Elderly Patients Admitted With Neurological Disorders Was Not Predicted by any Particular Diagnosis in a Tertiary Medical Center

Bacellar, Aroldo; Assis, Telma; Pedreira, Bruno Bacellar; Costa, Gersonita; Nascimento, Osvaldo J. M.

doi:10.2174/1874205x01812010001

Cited by 5 publications

(3 citation statements)

References 39 publications

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“…Anthropometric characteristics of subjects in this study was similar to the data shown by Bacellar et al [13]. Female was the dominant gender, but with no statistically significance in stroke subjects.…”

Section: Discussionsupporting

confidence: 89%

In-hospital Mortality Among Neurological Patients over the Period of 5 years — a Retrospective, Single-center Study

Wiśniewski

2020

PNIN

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Introduction. Neurological disorders have been considered for many years dangerous and are associated with higher risk of in-hospital death. Brain vascular disorders are widely considered as the most severe and related to the highest mortality rate. Aim. The aim of the study was to assess the mortality rate in subjects hospitalized in the Neurology ward within 5 years, in particular the etiology, direct cause and predictability of deaths. Material and Methods. This study is retrospective. The documentation analysis concerned the last 5 years, i.e. from 2015 to 2019. From among the entire database of 8247 patients hospitalized in the Neurology Clinic of the University Hospital No. 1 in Bydgoszcz, 429 deaths were reported and analyzed. Results. The mortality rate was 5.2% among all subjects, 6.6% among all vascular patients and 1.16% among non-vascular subjects. The highest mortality was reported among hemorrhagic stroke (28.4%) and it was significantly higher compared to ischemic stroke (OR = 6.25, 95% CI 4.9–7.8, p < 0.0001). Patients with stroke had significantly higher mortality compared to other neurological disorders (OR = 11.08 95% CI 7.7–15.9, p < 0.0001). The main direct reason of death (80%) was primary cerebral as a result of baseline disease. 7% of deaths were considered as sudden, unexpected and 10.7% were related to complications developed during hospitalization. Conclusions. Stroke, especially hemorrhagic subtype, still remains the cause of the highest in-hospital mortality rate in the Neurology Ward. It is worth to notice that special attention should be paid to patients with coexisting infectious diseases, that contribute to higher mortality risk. (JNNN 2020;9(1):20–26) Key Words: in-hospital mortality, neurological disorders, stroke, prognosis

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Section: Discussionsupporting

confidence: 89%

In-hospital Mortality Among Neurological Patients over the Period of 5 years — a Retrospective, Single-center Study

Wiśniewski

2020

PNIN

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“…The Information Technology Department at this hospital (IT-HSR) recorded all admissions during the period of the study. Further information regarding the HSR and the method for capturing patients, including details concerning ND diagnostic assessments, can be found in our previously-published studies of the same population 15,16 . We enrolled elderly inpatients with NDs in this study using the following methods: 1) IT-HSR searches of NDs listed in discharge summaries and 2) IT-HSR identification of registered neurological procedures.…”

Section: Patientsmentioning

confidence: 99%

Predictors of readmission and long length of stay in elders admitted with neurological disorders in a tertiary center: a real-world investigation

Bacellar

Pedreira

Costa

et al. 2019

Arq. Neuro-Psiquiatr.

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Hospital readmission and long length of stay (LOS) increase morbidity and hospital mortality and are associated with excessive costs to health systems. Objective: This study aimed to identify predictors of hospital readmission and long LOS among elders with neurological disorders (NDs). Methods: Patients ≥ 60 years of age admitted to the hospital between January 1, 2009, and December 31, 2010, with acute NDs, chronic NDs as underpinnings of acute clinical disorders, and neurological complications of other diseases were studied. We analyzed demographic factors, NDs, and comorbidities as independent predictors of readmission and long LOS (≥ 9 days). Logistic regression was performed for multivariate analysis. Results: Overall, 1,154 NDs and 2,679 comorbidities were identified among 798 inpatients aged ≥ 60 years (mean 75.8 ± 9.1). Of the patients, 54.5% were female. Patient readmissions were 251(31%) and 409 patients (51%) had an LOS ≥ 9 days (95% confidence interval 48%–55%). We found no predictors for readmission. Low socioeconomic class (p = 0.001), respiratory disorder (p < 0.001), infection (p < 0.001), genitourinary disorder (p < 0.033), and arterial hypertension (p = 0.002) were predictors of long LOS. Identified risks of long LOS explained 22% of predictors. Conclusions: Identifying risk factors for patient readmission are challenges for neurology teams and health system stakeholders. As low socioeconomic class and four comorbidities, but no NDs, were identified as predictors for long LOS, we recommend studying patient multimorbidity as well as functional and cognitive scores to determine whether they improve the risk model of long LOS in this population.

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“…Studies of neurological disorders among elders admitted to a tertiary centre in Salvador found epilepsy in 16% of elderly inpatients, and the majority of them had a long LOS 9,10 . Notwithstanding these facts, reports of elderly inpatients admitted with epileptic seizures in Brazil are scarce 7,11,12,13,14,15,16 . The aim of the present study was to identify independent predictors of long LOS in a cohort of elderly inpatients who were admitted with epileptic seizures or experienced seizures during hospitalization.…”

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confidence: 99%

Predictors of long length of hospital stay among elders admitted with seizures in a tertiary centre: a prospective study

Bacellar

Assis

Pedreira

et al. 2020

Arq. Neuro-Psiquiatr.

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Population ageing is a global phenomenon, and life expectancy in Brazil is growing fast. Epilepsy is the third most important chronic neurological disorder, and its incidence is higher among elderly patients than in any other segment of the population. The prevalence of epilepsy is greater among inpatients than in the general population and it is related to long length of hospital stay (LOS), which is associated with hospital mortality and higher healthcare costs. Despite these facts, reports of elderly inpatients admitted with seizures and associated outcomes are scarce. Objective: To identify predictors of long LOS among elderly inpatients admitted with seizures. Methods: We prospectively enrolled elders admitted with epileptic seizures or who experienced seizures throughout hospitalization between November 2015 and August 2019. We analysed demographic data, neurological disorders, clinical comorbidities, and seizure features to identify risk factors. Results: The median LOS was 11 days, with an interquartile range (IQR) of 5-21 days. The frequency of long LOS (defined as a period of hospitalization ≥12 days) was 47%. Multivariate analysis showed there was an exponential increase in long LOS if a patient showed any of the following conditions: intensive care unit (ICU) admission (OR=4.562), urinary tract infection (OR=3.402), movement disorder (OR=5.656), early seizure recurrence (OR=2.090), and sepsis (OR=4.014). Conclusion: Long LOS was common among elderly patients admitted with seizures, and most predictors of long LOS found in this cohort might be avoidable; these findings should be confirmed with further research.

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Hospital Mortality Among Elderly Patients Admitted With Neurological Disorders Was Not Predicted by any Particular Diagnosis in a Tertiary Medical Center

Cited by 5 publications

References 39 publications

In-hospital Mortality Among Neurological Patients over the Period of 5 years — a Retrospective, Single-center Study

In-hospital Mortality Among Neurological Patients over the Period of 5 years — a Retrospective, Single-center Study

Predictors of readmission and long length of stay in elders admitted with neurological disorders in a tertiary center: a real-world investigation

Predictors of long length of hospital stay among elders admitted with seizures in a tertiary centre: a prospective study

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