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This study was carried out in response to the policy attention directed at older people discharged from hospital with ill-defined conditions, or signs and symptoms related disease. In England there has been an increase in incidence of this type of hospital admission and policy suggests that patients with these codes have fewer medical/physiological and more ‘social’ conditions that could be better managed in community settings. Currently however, this population has not been characterised. Description of the functional and physiological status of these patients is essential for the planning of future health and social care services. Patients with ill-defined conditions were described via a cross-sectional study of 80 patients aged over 70 years admitted to hospital with collapse/falls. Number of chronic diseases and prescribed medications were obtained from the medical records. Routine blood tests were taken and serum cytokine concentrations (IL-1β, IL-6, TNF-α, IFN-γ) were measured. Deprivation score, functional status, depression and the prevalence of frailty were ascertained. 35 patients received ill-defined condition codes, 45 received other codes. Patients with ‘illdefined conditions’ had normal routine blood results but very high serum concentrations of pro-inflammatory cytokines which did not correlate with number of chronic diseases indicating considerable medical problems. As the policy had suggested, they also had prevalent functional impairment (65.7%), high rates of frailty (77.1%) and pre-frailty (14.3%), and depression (42.9%). Patients with ill-defined conditions had poor outcomes evident in the high readmission (60%) and mortality (20%) rates. Patients were hospitalised for a statistically significantly shorter period than patients with other codes (p |
