The Association of Geriatric Syndromes with Hospital Outcomes

Romero-Ortuño, Román; Forsyth, Duncan R.; Wilson, Kathryn Jane; Cameron, Ewen; Wallis, Stephen; Biram, Richard; Keevil, Victoria L.

doi:10.12788/jhm.2685

Cited by 49 publications

(47 citation statements)

References 40 publications

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“…Eleven studies had a small sample size (range: 42‐395), were conducted in a single hospital (‐ward), or showed a sex distribution not representative of the PWD population . Thirty‐three studies met the criteria for comparability based on design or analysis, thereof 8 studies controlled or matched for 1 factor and 25 studies for at least 2 factors . Fourteen studies reported multivariate and descriptive results for LOS, and 5 studies solely multivariate results .…”

Section: Resultsmentioning

confidence: 99%

“…Thirty‐three studies met the criteria for comparability based on design or analysis, thereof 8 studies controlled or matched for 1 factor and 25 studies for at least 2 factors . Fourteen studies reported multivariate and descriptive results for LOS, and 5 studies solely multivariate results . Thirteen studies did not report any information on significance level …”

Section: Resultsmentioning

confidence: 99%

“…Seventeen studies across 7 countries were conducted in Europe: 3 studies each in Italy, Germany, Ireland, and the UK, 2 studies from Austria and Finland, as well as 1 study from Spain . The difference in LOS among PWD compared to PwoD ranged from 0.4 to 22 days .…”

Section: Resultsmentioning

confidence: 99%

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Length of hospital stay and dementia: A systematic review of observational studies

Möllers

Stocker

Wei

et al. 2018

Int J Geriat Psychiatry

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Objective Hospitalizations of people with dementia (PWD) are often accompanied by complications or functional loss and can lead to adverse outcomes. Unsystematic findings suggest an influence of comorbidities on the extent of differences in the length of hospital stay (LOS). This systematic review aimed to identify and evaluate all studies reporting LOS in PWD as compared to PwoD in general hospitals. Methods A systematic review of observational studies using PubMed and ISI Web of Knowledge. Inclusion criteria comprised original studies written in English or German, assessment of diagnosis of dementia, measurement of LOS, and comparison of people with and without dementia. Results Fifty‐two of 60 studies reported a longer hospitalization time for PWD compared to PwoD. The extent of the difference in LOS varied between and within countries as well as by type of primary morbidity (eg, injuries, cardiovascular diseases). The range of the LOS difference for studies without restriction to a primary morbidity was −2 to +22 days after matching or adjustment for a variable number and selection of potentially relevant covariates. For studies with injuries/fractures/medical procedures and infectious/vascular disease as the primary morbidity, the range was −2.9 to +12.4 and −11.2 to +21.8 days, respectively. Conclusions The majority of studies reported a longer hospitalization of PWD compared to PwoD. Length of hospital stay seems to be influenced by a variety of medical, social, organizational factors, including reasons for hospital admission, whose role should be explored in detail in further research.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Length of hospital stay and dementia: A systematic review of observational studies

Möllers

Stocker

Wei

et al. 2018

Int J Geriat Psychiatry

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“…The rate of institutionalisation in our cohort was 16.8%, which is relatively high in comparison to the overall (hospital-wide) institutionalisation rate in patients over 74 years old (9.9%). 13 This may refl ect the high clinical complexity of older PD patients requiring admission to our hospital. This is also consistent with previous observations that the progressive nature of PD often results in patients seeking long term care sooner than non-PD patients.…”

Section: Discussionmentioning

confidence: 99%

The Clinical Frailty Scale Predicts Inpatient Mortality in Older Hospitalised Patients with Idiopathic Parkinson'S Disease

Torsney

Romero-Ortuño

2018

Journal of the Royal College of Physicians of Edinburgh

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Parkinson's disease and frailty are both common conditions affecting older people. Little is known regarding the association of the Clinical Frailty Scale with hospital outcomes in idiopathic Parkinson's disease patients admitted to the acute hospital. We aimed to test whether frailty status was an independent predictor of short-term mortality and other hospital outcomes in older inpatients with idiopathic Parkinson's disease.Method We conducted an observational retrospective study in a large tertiary university hospital between October 2014 and October 2016. Routinely measured patient characteristics included demographics (age and sex), Clinical Frailty Scale, acute illness severity (Emergency Department Modi ed Early Warning Score), the Charlson Comorbidity Index, discharge specialty, history of dementia, history of depression and the presence of a new cognitive impairment. Outcomes studied were inpatient mortality, death within 30 days of discharge, new institutionalisation, length of stay ≥ 7 days and readmission within 30 days to the same hospital.Results There were 393 rst admission episodes of idiopathic Parkinson's disease patients aged 75 years or more; 166 (42.2%) were female. The mean age (standard deviation) was 82.8 (5.0) years. The mean Clinical Frailty Scale was 5.9 (1.4) and the mean Charlson Comorbidity Index was 1.3 (1.5). After adjustment for covariates, frailty and acute illness severity were independent predictors of inpatient mortality; odds ratio for severely/very severely frail or terminally ill = 8.1, 95% con dence interval 1.0-63.5, p = 0.045 and odds ratio for acute illness severity: 1.3, 95% con dence interval 1.1-1.6, p = 0.005). The Clinical Frailty Scale did not signi cantly predict other hospital outcomes.Conclusions The Clinical Frailty Scale was a signi cant predictor of inpatient mortality in idiopathic Parkinson's disease patients admitted to the acute hospital and it may be useful as a marker of risk in this vulnerable population.

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“…4,10 Measures All measures were collected during routine clinical care. All DME wards routinely practice Comprehensive Geriatric Assessment (CGA).…”

Section: Study Design and Settingmentioning

confidence: 99%

Health and social factors associated with a delayed discharge amongst inpatients in acute geriatric wards: A retrospective observational study

Moore

Hartley

Romero-Ortuño

2017

Geriatrics Gerontology Int

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The present results are consistent with previous reports that delayed discharges in older hospitalized patients are mainly related to new formal social care requirements in survivors of acute illness. Frailty was an independent risk factor for delay, but its effect might have been confounded by the unmeasured variable of informal care requirements. Our operational definition of delayed discharge does not mirror the legal definition of delayed transfer of care in England, and the results are not externally valid. Geriatr Gerontol Int 2018; 18: 530-537.

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The Association of Geriatric Syndromes with Hospital Outcomes

Abstract: BACKGROUND: Frailty, history of dementia (HoD), and acute confusional states (ACS) are common in older patients admitted to hospital.

Cited by 49 publications

References 40 publications

Length of hospital stay and dementia: A systematic review of observational studies

Length of hospital stay and dementia: A systematic review of observational studies

The Clinical Frailty Scale Predicts Inpatient Mortality in Older Hospitalised Patients with Idiopathic Parkinson'S Disease

Health and social factors associated with a delayed discharge amongst inpatients in acute geriatric wards: A retrospective observational study

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