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dc.contributor.authorRomero, Ortuno Romanen
dc.contributor.authorForsyth, Duncan Ren
dc.contributor.authorWilson, Janeen
dc.contributor.authorCameron, Ewenen
dc.contributor.authorWallis, Stephenen
dc.contributor.authorBiram, Richarden
dc.contributor.authorKeevil, Victoriaen
dc.date.accessioned2016-10-20T12:18:57Z
dc.date.available2016-10-20T12:18:57Z
dc.date.issued2016-02-01en
dc.identifier.issn1553-5592
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/260845
dc.description.abstractBackground Frailty, history of dementia (HoD), and acute confusional states (ACS) are common in older patients admitted to hospital. Objective To study the association of frailty (≥6 points in the Clinical Frailty Scale [CFS]), HoD, and ACS with hospital outcomes, controlling for age, gender, acute illness severity (measured by a Modified Early Warning Score in the emergency department), comorbidity (Charlson Comorbidity Index), and discharging specialty (general medicine, geriatric medicine, surgery). Design Retrospective observational study. Setting Large university hospital in England. Patients We analyzed 8202 first nonelective inpatient episodes of people aged 75 years and older between October 2014 and October 2015. Measurements The outcomes studied were prolonged length of stay (LOS ≥10 days), inpatient mortality, delayed discharge, institutionalization, and 30-day readmission. Statistical analyses were based on multivariate regression models. Results Independently of controlling variables, prolonged LOS was predicted by CFS ≥6: odds ratio (OR) =1.55; 95% confidence interval [CI], 1.36-1.77; P < 0.001; HoD: OR = 2.16; 95% CI, 1.79-2.61; P < 0.001; and ACS: OR = 3.31; 95% CI, 2.64-4.15; P < 0.001. Inpatient mortality was predicted by CFS ≥6: OR = 2.29; 95% CI, 1.79-2.94; P < 0.001. Delayed discharge was predicted by CFS ≥6: OR = 1.46; 95% CI, 1.27-1.67; P < 0.001; HoD: OR = 2.17; 95% CI, 1.80-2.62; P < 0.001; and ACS: OR = 2.29; 95% CI: 1.83-2.85; P < 0.001. Institutionalization was predicted by CFS ≥6: OR = 2.56; 95% CI, 2.09-3.14; P < 0.001; HoD: OR = 2.51; 95% CI, 2.00-3.14; P < 0.001; and ACS: OR 1.93; 95% CI, 1.46-2.56; P < 0.001. Readmission was predicted by ACS: OR = 1.36; 95% CI, 1.09-1.71; P = 0.006. Conclusions Routine screening for frailty, HoD, and ACS in hospitals may aid the development of acute care pathways for older adults.
dc.languageEnglishen
dc.language.isoenen
dc.publisherWiley
dc.subjecthospitalsen
dc.subjectfrail older adultsen
dc.subjectdementiaen
dc.subjectdeliriumen
dc.subjectgeriatric health servicesen
dc.titleThe association of geriatric syndromes with hospital outcomesen
dc.typeArticle
dc.description.versionThis is the author accepted manuscript. The final version is available from Wiley via http://www.journalofhospitalmedicine.com/jhospmed/article/130058/hospital-medicine/association-geriatric-syndromes-hospital-outcomesen
prism.endingPage89
prism.publicationDate2016en
prism.publicationNameJournal of Hospital Medicineen
prism.startingPage83
prism.volume12en
dc.identifier.doi10.17863/CAM.5995
dcterms.dateAccepted2016-08-25en
rioxxterms.versionAMen
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserveden
rioxxterms.licenseref.startdate2016-02-01en
dc.contributor.orcidKeevil, Victoria [0000-0001-6148-0640]
dc.identifier.eissn1553-5606
rioxxterms.typeJournal Article/Reviewen
dc.identifier.urlhttp://www.journalofhospitalmedicine.com/jhospmed/article/130058/hospital-medicine/association-geriatric-syndromes-hospital-outcomesen
rioxxterms.freetoread.startdate2018-02-01


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