Risk Factors of Increased Mortality During Hospitalization in Acutely-ill Elderly Patients with Altered State of Consciousness

Abstract

Introduction

A significant proportion of acutely ill hospitalised elderly patients have impaired consciousness and this has been associated with increased mortality. It remains unclear which factors underlie this relation. Identification of mortality predictors in this population is important to improve care.

Objectives

Determine if advanced age, cognitive impairment, high burden of comorbidities and poor functional status are predictors of increased mortality during hospitalisation in acutely-ill medical hospitalised elderly patients with altered state of consciousness.

Methods

All male patients (> 65 years) admitted to a medical ward (> 48 h) between 01/03/2015 to 31/08/2015 with delirium or RASS lower than–2 were included in the study. Patients were excluded if unable to be assessed due to sensorial deficits, communication problems or medical condition precluding the evaluation. Baseline evaluation included socio-demographic variables, RASS, CAM, IQCODE-SF, DSM-IV-TR criteria for dementia, Charlson Comorbidity Index and Barthel Index. The variables were entered in a logistic regression model (significance level < 0.05).

Results

The final sample consisted of 75 male subjects with altered state of consciousness, 14 of them died during hospitalisation. Dementia and Barthel Index were significantly associated with mortality during hospitalisation (P = 0.01 and P < 0.01, respectively). On the other hand, age and Charlson Co-morbidity Index were not associated significantly with mortality during hospitalisation (P = 0.22 and P = 0.1, respectively).

Conclusions

Acutely ill elderly patients with altered state of consciousness at admission have higher risk of death during hospitalisation if they have prior dementia or poor functional status. Health care should be improved to provide better response to this type of patients.

Disclosure of interest

The authors have not supplied their declaration of competing interest.