Dataset Information

Outcome of patients older than 85 years hospitalized in a neurology unit.

ABSTRACT:

Background

Advanced age is a major determinant of mortality and poor outcome at any level. In hospitalized patients, advanced age is a major issue in terms of prognosis, resource use, and therapeutic choices.

Aims

We aimed at assessing the 1 year outcome of elderly patients admitted to a neurology unit for various acute conditions.

Methods

Consecutive patients admitted to a neurology unit were enrolled and followed-up at 3, 6, and 12 months with structured phone interviews gathering information about mortality, disability, hospital readmissions, and place of residency. Inclusion criteria were age ≥ 85 years, availability of written consent and phone contact; no exclusion criteria were applied.

Results

Over a period of 16 months, 131 patients (88.8 ± 3.3, 92 females, 39 males) were admitted. The pre-hospitalization modified Rankin Scale (mRS) median (IQR) score, obtainable in 125 patients, was 2 (0, 3) and > 3 in 28/125 (22.4%) patients. Fifty-eight (46.8%) patients had pre-existing dementia (this information was missing for one patient). Eleven patients died during hospitalization. Of the 120 discharged patients, 60 (50%) were alive at 12 months, 41 died during follow-up (34.2%), and 19 (15.8%) were lost. At 12 months, out of the 60 alive patients, 29 (48.3%) had a mRS > 3. We did not detect predictors of 12-month survival. Predictors of 12-month worsening of functional status were pre-hospitalization mRS, pre-existing cognitive impairment, and male sex.

Conclusions

One-year mortality of elderly patients admitted to a neurology unit is extremely high. After one year, less than one fourth of elderly patients hospitalised for an acute neurological disease are left with only no-to-moderate disability.

SUBMITTER: Querzola G

PROVIDER: S-EPMC10363031 | biostudies-literature | 2023 Aug

REPOSITORIES: biostudies-literature

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Publications

Outcome of patients older than 85 years hospitalized in a neurology unit.

Querzola Giacomo G Bellomo Andrea A Salvadori Emilia E Pantoni Leonardo L

Aging clinical and experimental research 20230618 8

<h4>Background</h4>Advanced age is a major determinant of mortality and poor outcome at any level. In hospitalized patients, advanced age is a major issue in terms of prognosis, resource use, and therapeutic choices.<h4>Aims</h4>We aimed at assessing the 1 year outcome of elderly patients admitted to a neurology unit for various acute conditions.<h4>Methods</h4>Consecutive patients admitted to a neurology unit were enrolled and followed-up at 3, 6, and 12 months with structured phone interviews ...[more]

PMID: 37330922

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Project description:BackgroundSelecting appropriate outcome measures for vulnerable, multimorbid, older patients with acute and chronic impairments poses specific challenges, which may have caused inconsistent findings of previous intervention trials on early inpatient rehabilitation in acutely hospitalized older patients. The aim of this review was to describe primary outcome measures that have been used in randomized controlled trials (RCTs) on early rehabilitation in acutely hospitalized older patients, to analyze their matching, and to evaluate the effects of matching on the main findings of these RCTs.MethodsA systematic literature search was conducted in PubMed, Cochrane CENTRAL, CINAHL, and PEDro databases. Additional studies were identified through reference and citation tracking. Inclusion criteria were: RCT, patients aged ≥65 years, admission to an acute hospital medical ward (but not to an intensive medical care unit), physical exercise intervention (also as part of multidisciplinary programs), and primary outcome measure during hospitalization. Two independent reviewers extracted the data, assessed the methodological quality, and analyzed the matching of primary outcome measures to the intervention, study sample, and setting. Main study findings were related to the results of the matching procedure.ResultsTwenty-eight articles reporting on 24 studies were included. A total of 33 different primary outcome measures were identified, which were grouped into six categories: functional status, mobility status, hospital outcomes, adverse clinical events, psychological status, and cognitive functioning. Outcome measures differed considerably within each category and showed a large heterogeneity in their matching to the intervention, study sample, and setting. Outcome measures that specifically matched the intervention contents were more likely to document intervention-induced benefits. Mobility instruments seemed to be the most sensitive outcome measures to reveal such benefits.ConclusionsThis review highlights that the selection of outcome measures has to be highly specific to the intervention contents as this is a key factor to reveal benefits attributable to early rehabilitation in acutely hospitalized older patients. Inappropriate selection of outcome measures may represent a major cause of inconsistent findings reported on the effectiveness of early rehabilitation in this setting.Trial registrationPROSPERO CRD42017063978 .

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Dataset Information

Outcome of patients older than 85 years hospitalized in a neurology unit.

Background

Aims

Methods

Results

Conclusions

Publications

Outcome of patients older than 85 years hospitalized in a neurology unit.

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