Baseline Functional Status and One-year Mortality After Hospital Admission in Elderly Patients: a prospective cohort study
Introduction: Hospitalization represents a major factor that may precipitate the loss of functional status and the cascade into dependence. The main objective of our study was to determine the effect of functional status measured before hospital admission on survival at one year after hospitalizatio...
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| Formato: | Artículo revista |
| Lenguaje: | Inglés |
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Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología
2020
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| Acceso en línea: | https://revistas.unc.edu.ar/index.php/med/article/view/28771 |
| Aporte de: |
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I10-R327-article-28771 |
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| record_format |
ojs |
| institution |
Universidad Nacional de Córdoba |
| institution_str |
I-10 |
| repository_str |
R-327 |
| container_title_str |
Revista de la Facultad de Ciencias Médicas de Córdoba |
| language |
Inglés |
| format |
Artículo revista |
| topic |
activities of daily living frailty disable persons mortality aged actividades cotidianas fragilidad personas con discapacidad mortalidad anciano atividades cotidianas fragilidade pessoas com deficiência moratlidade idoso |
| spellingShingle |
activities of daily living frailty disable persons mortality aged actividades cotidianas fragilidad personas con discapacidad mortalidad anciano atividades cotidianas fragilidade pessoas com deficiência moratlidade idoso Sáenz, Victoria Zuljevic, Nicolas Elizondo, Cristina Martin Lesende, Iñaki Caruso, Diego Baseline Functional Status and One-year Mortality After Hospital Admission in Elderly Patients: a prospective cohort study |
| topic_facet |
activities of daily living frailty disable persons mortality aged actividades cotidianas fragilidad personas con discapacidad mortalidad anciano atividades cotidianas fragilidade pessoas com deficiência moratlidade idoso |
| author |
Sáenz, Victoria Zuljevic, Nicolas Elizondo, Cristina Martin Lesende, Iñaki Caruso, Diego |
| author_facet |
Sáenz, Victoria Zuljevic, Nicolas Elizondo, Cristina Martin Lesende, Iñaki Caruso, Diego |
| author_sort |
Sáenz, Victoria |
| title |
Baseline Functional Status and One-year Mortality After Hospital Admission in Elderly Patients: a prospective cohort study |
| title_short |
Baseline Functional Status and One-year Mortality After Hospital Admission in Elderly Patients: a prospective cohort study |
| title_full |
Baseline Functional Status and One-year Mortality After Hospital Admission in Elderly Patients: a prospective cohort study |
| title_fullStr |
Baseline Functional Status and One-year Mortality After Hospital Admission in Elderly Patients: a prospective cohort study |
| title_full_unstemmed |
Baseline Functional Status and One-year Mortality After Hospital Admission in Elderly Patients: a prospective cohort study |
| title_sort |
baseline functional status and one-year mortality after hospital admission in elderly patients: a prospective cohort study |
| description |
Introduction: Hospitalization represents a major factor that may precipitate the loss of functional status and the cascade into dependence. The main objective of our study was to determine the effect of functional status measured before hospital admission on survival at one year after hospitalization in elderly patients.
Methods: Prospective cohort study of adult patients (over 65 years of age) admitted to either the general ward or intensive Care units (ICU) of a tertiary teaching hospital in Buenos Aires, Argentina. Main exposure was the pre-admission functional status determined by means of the modified “VIDA” questionnaire, which evaluates the instrumental activities of daily living. We used a multivariate Cox proportional hazards model to estimate the effect of prior functional status on time to all-cause death while controlling for measured confounding. Secondarily, we analyzed the effect of post-discharge functional decline on long-term outcomes.
Results: 297 patients were included in the present study. 12.8% died during hospitalization and 86 patients (33.2%) died within one year after hospital discharge. Functional status prior to hospital admission, measured by the VIDA questionnaire (e.g., one point increase), was associated with a lower hazard of all-cause mortality during follow-up (Hazard Ratio [HR]: 0.96; 95% Confidence Interval [CI]: 0.94–0.98). Finally, functional decline measured at 15 days after hospital discharge, was associated with higher risk of all-cause death during follow-up (HR: 2.19, 95% CI: 1.09–4.37)
Conclusion: Pre-morbid functional status impacts long term outcomes after unplanned hospitalizations in elderly adults. Future studies should confirm these findings and evaluate the potential impact on clinical decision-making. |
| publisher |
Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología |
| publishDate |
2020 |
| url |
https://revistas.unc.edu.ar/index.php/med/article/view/28771 |
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2024-09-03T21:01:58Z |
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2024-09-03T21:01:58Z |
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I10-R327-article-287712024-08-27T18:28:25Z Baseline Functional Status and One-year Mortality After Hospital Admission in Elderly Patients: a prospective cohort study Funcionalidad basal y mortalidad al año del egreso hospitalario en adultos mayores: un estudio de cohorte prospectiva Funcionalidade basal e mortalidade um ano após a alta hospitalar em idosos: um estudo de coorte prospectivo Sáenz, Victoria Zuljevic, Nicolas Elizondo, Cristina Martin Lesende, Iñaki Caruso, Diego activities of daily living frailty disable persons mortality aged actividades cotidianas fragilidad personas con discapacidad mortalidad anciano atividades cotidianas fragilidade pessoas com deficiência moratlidade idoso Introduction: Hospitalization represents a major factor that may precipitate the loss of functional status and the cascade into dependence. The main objective of our study was to determine the effect of functional status measured before hospital admission on survival at one year after hospitalization in elderly patients. Methods: Prospective cohort study of adult patients (over 65 years of age) admitted to either the general ward or intensive Care units (ICU) of a tertiary teaching hospital in Buenos Aires, Argentina. Main exposure was the pre-admission functional status determined by means of the modified “VIDA” questionnaire, which evaluates the instrumental activities of daily living. We used a multivariate Cox proportional hazards model to estimate the effect of prior functional status on time to all-cause death while controlling for measured confounding. Secondarily, we analyzed the effect of post-discharge functional decline on long-term outcomes. Results: 297 patients were included in the present study. 12.8% died during hospitalization and 86 patients (33.2%) died within one year after hospital discharge. Functional status prior to hospital admission, measured by the VIDA questionnaire (e.g., one point increase), was associated with a lower hazard of all-cause mortality during follow-up (Hazard Ratio [HR]: 0.96; 95% Confidence Interval [CI]: 0.94–0.98). Finally, functional decline measured at 15 days after hospital discharge, was associated with higher risk of all-cause death during follow-up (HR: 2.19, 95% CI: 1.09–4.37) Conclusion: Pre-morbid functional status impacts long term outcomes after unplanned hospitalizations in elderly adults. Future studies should confirm these findings and evaluate the potential impact on clinical decision-making. Introducción: la hospitalización representa un factor que puede favorecer la pérdida de la funcionalidad. El objetivo principal de este estudio fue determinar el efecto de la funcionalidad previa a la admisión hospitalaria sobre la sobrevida al año del egreso, en pacientes adultos mayores. Métodos: este estudio de cohorte prospectiva incluyó pacientes de 65 años o mayores que fueron hospitalizados en la sala general o la unidad de terapia intensiva en un hospital universitario de la ciudad de Buenos Aires, Argentina. La funcionalidad basal fue medida a través del cuestionario VIDA modificado, el cual evalúa las actividades instrumentales de la vida diaria. Utilizamos un modelo multivariable de Cox para estimar el efecto de la funcionalidad basal sobre la sobrevida al año posterior al egreso, el cual permitió ajustar por potenciales confundidores. Además, analizamos el efecto de la funcionalidad luego del egreso hospitalario sobre la mortalidad al año del mismo. Resultados: se incluyeron 297 pacientes, de los cuales 12.8% fallecieron durante la hospitalización, y 86 pacientes (33.2%) fallecieron dentro del año del egreso hospitalario. Un aumento de un punto en la escala de la funcionalidad basal (es decir, mejor funcionalidad), se asoció a una disminución en el riesgo de muerte al año del egreso (Hazard Ratio [HR]: 0.96; Intervalo de confianza [IC] 95%: 0.94–0.98). Por ultimo, la declinación funcional posterior al egreso hospitalario se asoció a un mayor riesgo de muerte durante el seguimiento (HR: 2.19, IC 95%: 1.09–4.37). Conclusión: la funcionalidad previa a la hospitalización de los adultos mayores impacta en los resultados a largo plazo luego de una hospitalización. Introdução: a hospitalização representa um fator que pode favorecer a perda de funcionalidade. O principal objetivo deste estudo foi determinar o efeito da funcionalidade anterior à admissão hospitalar na sobrevida um ano após a alta em pacientes idosos. Métodos: Este estudo de coorte prospectivo incluiu pacientes com 65 anos ou mais de idade internados na enfermaria ou unidade de terapia intensiva de um hospital universitário da cidade de Buenos Aires, Argentina. A funcionalidade da linha de base foi medida através do questionário VIDA modificado, que avalia as atividades instrumentais da vida diária. Utilizamos um modelo multivariável de Cox para estimar o efeito da funcionalidade da linha de base na sobrevida um ano após a alta, o que permitiu o ajuste para possíveis fatores de erro. Além disso, tambem foi avaliado o efeito da funcionalidade após a alta hospitalar na mortalidade um ano após a alta. Resultados: foram incluídos 297 pacientes, dos quais 12,8% obitaram durante a internação e 86 pacientes (33,2%) foram a óbito dentro de um ano após a alta hospitalar. Um aumento de um ponto na escala da funcionalidade da linha de base (ou seja, melhor funcionalidade) foi associado a uma diminuição do risco de morte um ano após a alta (Hazard Ratio [HR]: 0,96; Intervalo de Confiança [IC] 95) %: 0,94-0,98). Finalmente, o declínio funcional após a alta foi associado a um risco aumentado dos casos de óbito durante o acompanhamento (HR: 2,19, IC 95%: 1,09–4,37). Conclusão: a funcionalidade anterior à hospitalização dos idosos afeta os resultados a longo prazo após a hospitalização. Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología 2020-08-21 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion text/html application/pdf https://revistas.unc.edu.ar/index.php/med/article/view/28771 10.31053/1853.0605.v77.n3.28771 Revista de la Facultad de Ciencias Médicas de Córdoba.; Vol. 77 No. 3 (2020); 143-148 Revista de la Facultad de Ciencias Médicas de Córdoba; Vol. 77 Núm. 3 (2020); 143-148 Revista da Faculdade de Ciências Médicas de Córdoba; v. 77 n. 3 (2020); 143-148 1853-0605 0014-6722 10.31053/1853.0605.v77.n3 eng https://revistas.unc.edu.ar/index.php/med/article/view/28771/31076 https://revistas.unc.edu.ar/index.php/med/article/view/28771/31077 Derechos de autor 2020 Universidad Nacional de Córdoba https://creativecommons.org/licenses/by-nc/4.0 |