1. Risk factors for three-month mortality after discharge in a cohort of non-oncologic hospitalized elderly patients: Results from the REPOSI study
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Luca, Pasina, Laura, Cortesi, Mara, Tiraboschi, Alessandro, Nobili, Giovanna, Lanzo, Mauro, Tettamanti, Carlotta, Franchi, Pier Mannuccio Mannucci, Silvia, Ghidoni, Andrea, Assolari, Antonio, Brucato, Domenico, Prisco, Elena, Silvestri, Caterina, Cenci, Giacomo, Emmi, Gianni, Biolo, Gianfranco, Guarnieri, Michela, Zanetti, Giovanni, Fernandes, Massimo, Vanoli, Giulia, Grignani, Gianluca, Casella, Mauro, Bernardi, Silvia Li Bassi, Luca, Santi, Giacomo, Zaccherini, Elmo, Mannarino, Graziana, Lupattelli, Vanessa, Bianconi, Francesco, Paciullo, Ranuccio, Nuti, Roberto, Valenti, Martina, Ruvio, Silvia, Cappelli, Alberto, Palazzuoli, Teresa, Salvatore, Ferdinando Carlo Sasso, Domenico, Girelli, Oliviero, Olivieri, Thomas, Matteazzi, Mario, Barbagallo, Lidia, Plances, Roberta, Alcamo, Giuseppe, Licata, Luigi, Calvo, Maria, Valenti, Marco, Zoli, Raffaella, Arnò, Franco Laghi Pasini, Pier Leopoldo Capecchi, Maurizio, Bicchi, Giuseppe, Palasciano, Maria Ester Modeo, Maria, Peragine, Fabrizio, Pappagallo, Stefania, Pugliese, Carla Di Gennaro, Alfredo, Postiglione, Maria Rosaria Barbella, Francesco De Stefano, Maria Domenica Cappellini, Giovanna, Fabio, Sonia, Seghezzi, Margherita Migone De Amicis, Daniela, Mari, Paolo Dionigi Rossi, Sarah, Damanti, Barbara Brignolo Ottolini, Gino Roberto Corazza, Emanuela, Miceli, Marco Vincenzo Lenti, Donatella, Padula, Giovanni, Murialdo, Alessio, Marra, Federico, Cattaneo, Maria Beatrice Secchi, Davide, Ghelfi, Luigi, Anastasio, Lucia, Sofia, Maria, Carbone, Giovanni, Davì, Maria Teresa Guagnano, Simona, Sestili, Gerardo, Mancuso, Daniela, Calipari, Mosè, Bartone, Maria Rachele Meroni, Paolo Cavallo Perin, Bartolomeo, Lorenzati, Gabriella, Gruden, Graziella, Bruno, Cristina, Amione, Paolo, Fornengo, Rodolfo, Tassara, Deborah, Melis, Lara, Rebella, Giuseppe, Delitala, Vincenzo, Pretti, Maristella Salvatora Masala, Luigi, Bolondi, Leonardo, Rasciti, Ilaria, Serio, Filippo Rossi Fanelli, Antonio, Amoroso, Alessio, Molfino, Enrico, Petrillo, Giuseppe, Zuccalà, Francesco, Franceschi, Guido De Marco, Cordischi, Chiara, Sabbatini, Marta, Giuseppe, Romanelli, Claudia, Amolini, Deborah, Chiesa, Alessandra, Marengoni, Antonio, Picardi, Umberto Vespasiani Gentilucci, Paolo, Gallo, Giorgio, Annoni, Maurizio, Corsi, Sara, Zazzetta, Giuseppe, Bellelli, Franco, Arturi, Elena, Succurro, Mariangela, Rubino, Giorgio, Sesti, Paola, Loria, Maria Angela Becchi, Gianfranco, Martucci, Alessandra, Fantuzzi, Mauro, Maurantonio, Stefano, Carta, Sebastiana, Atzori, Maria Grazia Serra, Maria Antonietta Bleve, Laura, Gasbarrone, Maria Rosaria Sajeva, Paola Di Corato, Giancarlo, Agnelli, Emanuela, Marchesini, Fabrizio, Fabris, Michela, Carlon, Francesca, Turatto, Aldo, Baritusso, Manfredini, Roberto, Christian, Molino, Marco, Pala, Fabbian, Fabio, Benedetta, Boari, Alfredo De Giorgi, Giuseppe, Paolisso, Maria Rosaria Rizzo, Maria Teresa Laieta, Giovanbattista, Rini, Pasquale, Mansueto, Ilenia, Pepe, Claudio, Borghi, Enrico, Strocchi, Valeria De Sando, Carlo, Sabbà, Francesco Saverio Vella, Patrizia, Suppressa, Raffaella, Valerio, Caterina, Capobianco, Luigi, Fenoglio, Christian, Bracco, Alessia Valentina Giraudo, Elisa, Testa, Cristina, Serraino, Silvia, Fargion, Paola, Bonara, Giulia, Periti, Marianna, Porzio, Flora, Peyvandi, Alberto, Tedeschi, Raffaella, Rossio, Valter, Monzani, Valeria, Savojardo, Christian, Folli, Maria, Magnini, Francesco, Salerno, Alessio, Conca, Giulia, Gobbo, Balduini, Carlo L., Giampiera, Bertolino, Stella, Provini, Federica, Quaglia, Franco, Dallegri, Luciano, Ottonello, Luca, Liberale, Wu Sheng Chin, Laura, Carassale, Silvia, Caporotundo, Giancarlo, Traisci, Lucrezia De Feudis, Silvia Di Carlo, Nicola Lucio Liberato, Alberto, Buratti, Tiziana, Tognin, Giovanni Battista Bianchi, Sabrina, Giaquinto, Francesco, Purrello, Antonino Di Pino, Salvatore, Piro, Renzo, Rozzini, Lina, Falanga, Giuseppe, Montrucchio, Elisabetta, Greco, Pietro, Tizzani, Paolo, Petitti, Antonio, Perciccante, Alessia, Coralli, Raffaella, Salmi, Piergiorgio, Gaudenzi, Susanna, Gamberini, Andrea, Semplicini, Lucia, Gottardo, Gianluigi, Vendemiale, Gaetano, Serviddio, Roberta, Forlano, Cesare, Masala, Antonio, Mammarella, Raparelli, Valeria, Francesco, Violi, Stefania, Basili, Ludovica, Perri, Raffaele, Landolfi, Massimo, Montalto, Antonio, Mirijello, Carla, Vallone, Martino, Bellusci, Donatella, Setti, Filippo, Pedrazzoli, Luigina, Guasti, Luana, Castiglioni, Andrea, Maresca, Alessandro, Squizzato, Marta, Molaro, Marco, Bertolotti, Chiara, Mussi, Maria Vittoria Libbra, Andrea, Miceli, Elisa, Pellegrini, Lucia, Carulli, Francesco, Perticone, Angela, Sciacqua, Michele, Quero, Chiara, Bagnato, Roberto, Corinaldesi, DE GIORGIO, Roberto, Mauro, Serra, Valentina, Grasso, Eugenio, Ruggeri, Andrea, Salvi, Roberto, Leonardi, Chiara, Grassini, Ilenia, Mascherona, Giorgio, Minelli, Francesca, Maltese, Armando, Gabrielli, Massimo, Mattioli, William, Capeci, Giuseppe Pio Martino, Salvatore, Corrao, Silvia, Messina, Riccardi, Ghio, Serena, Favorini, Anna Dal Col, Salvatore, Minisola, Luciano, Colangelo, Antonella, Afeltra, Pamela, Alemanno, Benedetta, Marigliano, Pietro, Castellino, Julien, Blanco, Luca, Zanoli, Marco, Cattaneo, Paola, Fracasso, Maria Valentina Amoruso, Valter, Saracco, Marisa, Fogliati, Carlo, Bussolino, Vittorio, Durante, Giovanna, Eusebi, Daniela, Tirotta, Francesca, Mete, Miriam, Gino, Antonio, Cittadini, Michele, Arcopinto, Andrea, Salzano, Emanuele, Bobbio, Alberto Maria Marra, Domenico, Sirico, Guido, Moreo, Francesco, Scopelliti, Francesca, Gasparini, Melissa, Cocca, Nieves Ramirez Duque, Alberto Muela Molinero, Pedro Abad Requejo, Vanessa Lopez Pelaez, Lara, Tamargo, Xavier Corbella Viros, Francesc, Formiga, Jesus Diez Manglano, Esperanza Bejarano Tello, Esther Del Corral Behamonte, Maria Sevil Puras, Manuel, Romero, Blanca Pinilla Llorente, Cristina Lopez Gonzalez-Cobos, Victoria Villalba Garcia, M., Juan Bosco Lopez Saez, Susana Sanz Baena, Marta Arroyo Gallego, Concepcion Gonzalez Becerra, Antonio Fernandez Moyano, Mercedes Gomez Hernandez, Manuel Poyato Borrego, Raquel Pacheco Cuadros, Florencia Perez Rojas, Beatriz Garcia Olid, Sara Carrascosa Garcia, Alfonso Gonzalez-Cruz Cervellera, Marta Peinado Martinez, Alberto Ruiz Cantero, Antonio Albarracín Arraigosa, Montserrat Godoy Guerrero, Miguel Angel Barón Ramos, Jose Manuel Machin, Ignacio Novo Veleiro, Lucia Alvela Suarez, Alfonso, Lopez, David Rubal Bran, Iria Iñiguez Vazquez, and Monica Rios, Prego.
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Male ,Aging ,Pediatrics ,Health (social science) ,Bedridden ,030204 cardiovascular system & hematology ,Logistic regression ,DISEASE ,PALLIATIVE CARE ,Bedridden Persons ,0302 clinical medicine ,Risk Factors ,80 and over ,Medicine ,030212 general & internal medicine ,Hypoalbuminemia ,Prospective Studies ,Prospective cohort study ,PREDICTORS ,Aged, 80 and over ,Frailty ,Mortality ,Prognosis ,Aged ,Female ,Follow-Up Studies ,Frail Elderly ,Hospital Units ,Humans ,Internal Medicine ,Italy ,Logistic Models ,Patient Discharge ,Absolute risk reduction ,CANCER ,Severe dementia ,Cohort ,medicine.medical_specialty ,Renal function ,Socio-culturale ,ILLNESS ,VALIDATION ,03 medical and health sciences ,SCORE ,OLDER PATIENTS ,business.industry ,Mortality, Bedridden, Prognosis, Frailty, PALLIATIVE CARE, 6-MONTH MORTALITY, OLDER PATIENTS, VALIDATION, DISEASE, SCORE, PREDICTORS, ILLNESS, CANCER, ADULTS ,ADULTS ,medicine.disease ,6-MONTH MORTALITY ,Physical therapy ,Geriatrics and Gerontology ,business ,Gerontology - Abstract
Background Short-term prognosis, e.g. mortality at three months, has many important implications in planning the overall management of patients, particularly non-oncologic patients in order to avoid futile practices. The aims of this study were: i) to investigate the risk of three-month mortality after discharge from internal medicine and geriatric wards of non-oncologic patients with at least one of the following conditions: permanent bedridden status during the hospital stay; severely reduced kidney function; hypoalbuminemia; hospital admissions in the previous six months; severe dementia; ii) to establish the absolute risk difference of three-month mortality of bedridden compared to non-bedridden patients. Methods This prospective cohort study was run in 102 Italian internal medicine and geriatric hospital wards. The sample included all patients with three-months follow-up data. Bedridden condition was defined as the inability to walk or stand upright during the whole hospital stay. The following parameters were also recorded: estimated GFR ≤ 29 mL/min/1.73 m2; severe dementia; albuminemia ≪2.5 g/dL; hospital admissions in the six months before the index admission. Results Of 3915 patients eligible for the analysis, three-month follow-up were available for 2058, who were included in the study. Bedridden patients were 112 and the absolute risk difference of mortality at three months was 0.13 (CI 95% 0.08–0.19, p ≪ 0.0001). Logistic regression analysis also adjusted for age, sex, number of drugs and comorbidity index found that bedridden condition (OR 2.10, CI 95% 1.12–3.94), severely reduced kidney function (OR 2.27, CI 95% 1.22–4.21), hospital admission in the previous six months (OR 1.96, CI 95% 1.22–3.14), severe dementia (with total or severe physical dependence) (OR 4.16, CI 95% 2.39–7.25) and hypoalbuminemia (OR 2.47, CI 95% 1.12–5.44) were significantly associated with higher risk of three-month mortality. Conclusions Bedridden status, severely reduced kidney function, recent hospital admissions, severe dementia and hypoalbuminemia were associated with higher risk of three-month mortality in non-oncologic patients after discharge from internal medicine and geriatric hospital wards.
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- 2018