Activities of daily living at hospital admission and estimated survival time of older patients.

Autor:	Ryg J; Department of Geriatric Medicine, Odense University Hospital, Odense, Denmark.; Geriatric Research Unit, Department of Clinical Research, University of Southern Denmark, Odense, Denmark., Engberg H; Research Unit of Clinical Epidemiology, Department of Clinical Research, University of Southern Denmark, Odense, Denmark.; Center for Clinical Epidemiology, Odense University Hospital, Odense, Denmark., Anru PL; Research Unit of Clinical Epidemiology, Department of Clinical Research, University of Southern Denmark, Odense, Denmark.; Center for Clinical Epidemiology, Odense University Hospital, Odense, Denmark., Pedersen SGH; Medical Department, Holbæk Hospital, Holbæk, Denmark., Jorgensen MG; Department of Geriatric Medicine, Aalborg University Hospital, Aalborg, Denmark., Vinding KL; Medical Department, Kolding Hospital, Kolding, Denmark.; Medical Department, Odense University Hospital, Svendborg, Denmark., Masud T; Department of Geriatric Medicine, Odense University Hospital, Odense, Denmark.; Geriatric Research Unit, Department of Clinical Research, University of Southern Denmark, Odense, Denmark.; Department of Geriatric Medicine, Nottingham University Hospital, Nottingham, UK., Andersen-Ranberg K; Department of Geriatric Medicine, Odense University Hospital, Odense, Denmark.; Geriatric Research Unit, Department of Clinical Research, University of Southern Denmark, Odense, Denmark.
Jazyk:	angličtina
Zdroj:	Age and ageing [Age Ageing] 2021 Jun 28; Vol. 50 (4), pp. 1200-1207.
DOI:	10.1093/ageing/afaa251
Abstrakt:	Background: Predicting expected survival time in acutely hospitalised older patients is a clinical challenge. Objective: To examine if activities of daily living (ADL) assessed by Barthel-Index-100 (Barthel-Index) at hospital admission adds useful information to clinicians on expected survival time in older patients. Methods: A nationwide population-based cohort study was used. All patients aged ≥65 years in the National Danish Geriatric Database from 2005 to 2014 were followed up until death, emigration or study termination (31 December 2015). Individual data were linked to national health registers. Barthel-Index was categorised into five-point subcategories with a separate category of Barthel-Index = 0. Kaplan-Meier analysis was used to assess crude survival proportions (95% CI) and Cox regression to examine association of Barthel-Index and mortality adjusting for age, Charlson comorbidity index, medication use, BMI, marital status, prior hospitalisations and admission year. Results: In total, 74,589 patients (63% women) aged (mean (SD)) 82.5(7.5) years with Barthel-Index (median (IQR)) 54(29-77) were included. In patients with Barthel-Index = 100-96 crude survival was 0.96(0.95-0.97) after 90-days, 0.88(0.87-0.89) after 1-year, and 0.79(0.78-0.80) after 2-years. Corresponding survival in patients with Barthel-Index = 0 was 0.49(0.47-0.51), 0.35(0.34-0.37) and 0.26(0.24-0.27). Decreasing Barthel-Index was associated with increasing mortality in the multivariable analysis. In women with Barthel-Index = 0, the mortality risk (HR (95% CI)) was 14.74(11.33-19.18) after 90-days, 8.40(7.13-9.90) after 1-year and 6.22(5.47-7.07) after 2-years using Barthel-Index = 100-96 as reference. In men, the corresponding risks were 11.36(8.81-14.66), 6.22(5.29-7.31) and 5.22(4.56-5.98). Conclusions: ADL measured by Barthel-Index provides useful, easily accessible and independent information to clinicians on expected survival time in patients admitted to a geriatric department. (© The Author(s) 2020. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu