Factors associated with in-hospital mortality in octogenarians managed by geriatric service in a referral hospital in Colombia.

Abstract

Introduction: The demographic transition has significantly increased the number of hospitalizations in octogenarian patients. Previous studies have documented the importance of clinical, functional, and cognitive variables for in-hospital mortality risk, but their frequency and importance in Latin American populations is yet to be described. It is important because Colombia has multiple ethnic races, with different types of longevity, and we have a history of social violence that affects our life expectancy. The aim of this study is to define which risk factors are associated with in-hospital mortality in octogenarians, and how frequent they are and quantify the weight of each of these factors in the outcomes.

Methodology: We present an analytical observational retrospective cohort study in adult patients over 80 years of age hospitalized and followed by the geriatrics service at Hospital Universitario San Ignacio (Bogotá, Colombia). The association between in-hospital mortality and multiple clinical, functional, and cognitive variables was evaluated by means of univariate and multivariate logistic regression analysis.

Results: A total of 1235 hospitalizations were analyzed (age 85.5 ± 4.4 years, 58.62% women). Malnutrition was documented in 22.4%, dependency for basic activities (Barthel ⩽ 95) in 75.9%, and positive screening for frailty (FRAIL ⩾ 3) in 55.3%. Mortality was 5.67%. Factors independently associated with mortality were history of cancer (Odds ratio (OR): 2.31; 95% Confidence interval (CI): 1.34-3.98, p < 0.003), delirium (OR: 2.48; 95% CI: 1.44-4.28, p < 0.001), malnutrition (OR: 2.50; 95% CI: 1.46-4.28; p = 0.001), frailty (OR: 2.25; 95% CI: 1.13-4.45, p = 0.019), tachypnea on admission (OR: 1.09; 95% CI: 1.03-1.14, p = 0.002), and creatinine elevation (OR: 2.47; 95% CI: 1.47-4.15, p = 0.001).

Conclusion: Factors easily identifiable at hospital admission and amenable to intervention could predict an increased risk of mortality in octogenarian patients, such as the presence of malnutrition, frailty, and delirium. These findings facilitate the estimation of mortality risk and serve as a starting point to investigate the potential benefit of early interventions in this population.