[Who survives in a nursing home? Situational analysis of mortality in the nursing home and study of evaluation criteria of prognostic value].

The nursing home plays an increasing role as domicile in the last period of life. The following investigation is an assessment of the mortality after entering a nursing home, and an analysis of the mental and physical condition of the residents with the goal of being able to differentiate at admission to a nursing home between short-term and long-term "survivors". Of 317 nursing home residents, the initial physical examination upon admission was investigated retrospectively. The nursing home residents were divided into six groups according to their survival time: survival-time up to 1 week, > 1 week to 1 month, > 1 month to 6 month, > 6 month to 1 year, > 1 year to 5 years, and > 5 years. The mean age of the group studied at admission was 80 years; 75% of the residents were transferred from a hospital. On the average, six diseases or chronic disabilities per patient were diagnosed upon admission to the nursing home. The mean survival time was 2.7 years. The initial phase after admission was the most critical period with a high mortality in the first six months (41% of all nursing home residents); of these, 81% had died already within the first month. The assessment criteria, i. e., the level of communicative abilities, orientation, mobility, and urinary/fecal continence, were found to bear a close relation to survival time. Thus, an important prognostic role as "survival predictors" can be ascribed to these factors.(ABSTRACT TRUNCATED AT 250 WORDS)