Indicateurs précoces de durée de séjour prolongée chez les sujets âgés: étude pilote réalisée au CHRU de Strasbourg [Early indicators of prolonged hospitalization of the elderly: pilot study at Strasbourg University Hospital].

Détails

ID Serval
serval:BIB_C73C419592BB
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Indicateurs précoces de durée de séjour prolongée chez les sujets âgés: étude pilote réalisée au CHRU de Strasbourg [Early indicators of prolonged hospitalization of the elderly: pilot study at Strasbourg University Hospital].
Périodique
Presse Médicale
Auteur(s)
Lang P.O., Heitz D., Meyer N., Dramé M., Jovenin N., Ankri J., Somme D., Novella J.L., Gauvain J.B., Colvez A., Couturier P., Lanièce I., Voisin T., de Wazières B., Gonthier R., Jeandel C., Jolly D., Saint-Jean O., Blanchard F.
ISSN
0755-4982 (Print)
ISSN-L
0755-4982
Statut éditorial
Publié
Date de publication
2007
Peer-reviewed
Oui
Volume
36
Numéro
3 Pt 1
Pages
389-398
Langue
français
Notes
Publication types: Comparative Study ; English Abstract ; Evaluation Studies ; Journal Article Publication Status: ppublish
Résumé
OBJECTIVES: The aim of this study was to identify early indicators of prolonged hospital stays by elderly patients.
METHODS: This prospective pilot study, conducted at Strasbourg University Hospital, included patients aged 75 years or older who were hospitalized via the emergency department (SAFES cohort: Sujet Agé Fragile: Evaluation et suivi, that is, Frail Elderly Subjects: Evaluation and Follow-up). A gerontologic evaluation of these patients during the first week of their hospitalization furnished the data for an exact logistic regression. Two definitions were used for prolonged hospitalization: 30 days and a composite number adjusted for diagnosis-related group according to the French classification (f-DRG).
RESULTS: The analysis examined 137 hospitalizations. More than two thirds of the patients were women (73%), with a mean age of 84 years. Twenty-four hospitalizations (17%) lasted more than 30 days, but only 6 (4%) lasted beyond the DRG-adjusted limit. No social or demographic variables appeared to affect the length of stay, regardless of the definition of prolonged stay. No indicator was associated with the 30-day limit, but clinical markers were linked to prolongation assessed by f-DRG adjustment. A "risk of malnutrition" (OR=14.07) and "mood disorders" (OR=2,5) were both early markers for prolonged hospitalization. Although not statistically significant, "walking difficulties" (OR=2.72) and "cognitive impairment" (OR=5.03) appeared to be associated with prolonged stays. No association was seen with either the variables measured by Katz's Activities of Daily Living Index or its course during hospitalization.
CONCLUSION: Our study shows that when generally recognized indicators of frailty are taken into account, a set of simple items enables a predictive approach to the prolongation of emergency hospitalizations of the elderly.
Mots-clé
Age Factors, Aged, Aged, 80 and over, Cognition Disorders, Cohort Studies, Diagnosis-Related Groups, Female, Follow-Up Studies, Frail Elderly, Geriatric Assessment, Humans, Length of Stay, Logistic Models, Male, Pilot Projects, Prospective Studies, Risk Factors, Sex Factors, Socioeconomic Factors, Walking
Pubmed
Web of science
Création de la notice
15/04/2015 9:44
Dernière modification de la notice
03/03/2018 21:19
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