Sterfte en functieverlies na ziekenhuisverblijf

Objective

To study the clinical characteristics, mortality and loss of function in acutely admitted elderly patients who had been assigned to various risk categories for functional decline.

Design

Descriptive, prospective cohort research at three hospitals in the Netherlands.

Method

Between 2006 and 2009, consecutive patients ≥ 65 years, acutely admitted and hospitalised for at least 48 hours were eligible. Besides acute and chronic illnesses, 19 common geriatric conditions were assessed upon hospital admission and mortality and functional decline were assessed three and twelve months after admission. The patients were placed in risk categories for functional decline (low, intermediate or high risk) according to their ISAR-HP (Identification of Seniors at Risk-Hospitalized Patients) scores.

Results

A total of 639 patients were included, with a mean age of 78 years. Overall, 27%, 33% and 40% of the patients were at low, intermediate or high risk for functional decline, respectively. Low-risk patients had fewer geriatric conditions (mean 2.2) compared with those at high risk (mean 5.1 geriatric conditions). Twelve months after admission, 69% of the latter group had irreversible function loss or had died.

Conclusion

By using a simple risk assessment instrument at hospital admission, the patients could be classified in risk categories with distinct clinical characteristics and outcomes of hospital treatments. This approach could be useful for the appropriate tailoring of patient care in clinical practice.

Conflict of interest: none declared. Financial support: none declared.