Measuring the impact of hospitalisation for infectious diseases on the quality of life of older patients in four European countries: the AEQUI longitudinal matched cohort study (2020-2023).

Abstract

Objectives: To evaluate the impact of hospitalisation for infectious diseases on the Health-Related Quality of life (HRQOL), multidimensional frailty, and functioning of older patients, we conducted a longitudinal matched cohort study in four European countries.

Methods: HRQOL, frailty, and functioning were assessed using validated questionnaires at inclusion, at discharge, and up to six months later (M6) in patients aged over 65 years hospitalised for severe acute respiratory or bloodstream infections, and matched controls hospitalised for non-infectious conditions. Comparative analyses employed multilevel mixed-effect linear or logistic models to assess changes from inclusion.

Results: Between 2020 and 2023, 1,968 patients aged 65 to 100 years (mean: 81) were included; 1,064 (54.1%) were male and 59 (3%) were institutionalised. Of these 1,968 patients, 826 were hospitalised for infectious diseases and 1,142 for non-infectious conditions. At inclusion, EQ-5D-3L (European Quality of life 5 Dimensions and 3 Lines) scores ranged from -0.7 to 1 (full HRQOL), with a median of 0.7 across all visits and groups. Compared to controls, patients hospitalised for infectious diseases had lower scores on the Activities of Daily Living (ADL) scale (median, 4.5 vs 5.0; p=0.020) and the Instrumental Activities of Daily Living (IADL) scale (median, 3.0 vs 4.0; p<0.001). At discharge, IADL scores were lower in patients hospitalised for infectious diseases than in controls (median, 4.0 vs 5.0, p=0.003), indicating reduced functioning. The proportion of frail patients, determined by a Multidimensional Prognostic Index (MPI) score between 0.67 and 1, was significantly higher among patients hospitalised for infectious diseases (n=113/801, 14.1%) than controls (n=108/1,111, 9.7%; p=0.012). At M6, no statistically significant differences were observed between groups in changes from inclusion in HRQOL (EQ-5D-3L, p=0.436), frailty (MPI, p=0.269), and functioning (ADL, p=0.993).

Conclusions: Hospitalisation for infectious diseases and non-infectious diseases or conditions had a similar impact on HRQOL in non-institutionalised older adults.

Registration number: Clinical trials: NCT04825132.