A prospective cohort study of geriatric syndromes among older medical patients admitted to acute care hospitals

TitleA prospective cohort study of geriatric syndromes among older medical patients admitted to acute care hospitals
Publication TypeJournal Article
Year of Publication2011
AuthorsLakhan P., Jones M., Wilson A., Courtney M., Hirdes J., Gray L.C
JournalJ Am Geriatr Soc
Volume59
Issue11
Pagination2001-8
Date PublishedNov
ISBN Number0002-8614
Accession Number22092231
Keywords*Activities of Daily Living, *Hospitalization, Acute Disease/epidemiology/*therapy, Aged, Aged, 80 and over, Female, Follow-Up Studies, Frail Elderly/*statistics & numerical data, Geriatric Assessment/*methods, Humans, Incidence, Male, Prognosis, Prospective Studies, Queensland/epidemiology, Risk Factors, Syndrome
Abstract

OBJECTIVES: To identify the prevalence of geriatric syndromes in the premorbid for all syndromes except falls (preadmission), admission, and discharge assessment periods and the incidence of new and significant worsening of existing syndromes at admission and discharge. DESIGN: Prospective cohort study. SETTING: Three acute care hospitals in Brisbane, Australia. PARTICIPANTS: Five hundred seventy-seven general medical patients aged 70 and older admitted to the hospital. MEASUREMENTS: Prevalence of syndromes in the premorbid (or preadmission for falls), admission, and discharge periods; incidence of new syndromes at admission and discharge; and significant worsening of existing syndromes at admission and discharge. RESULTS: The most frequently reported premorbid syndromes were bladder incontinence (44%), impairment in any activity of daily living (ADL) (42%). A high proportion (42%) experienced at least one fall in the 90 days before admission. Two-thirds of the participants experienced between one and five syndromes (cognitive impairment, dependence in any ADL item, bladder and bowel incontinence, pressure ulcer) before, at admission, and at discharge. A majority experienced one or two syndromes during the premorbid (49.4%), admission (57.0%), or discharge (49.0%) assessment period. The syndromes with a higher incidence of significant worsening at discharge (out of the proportion with the syndrome present premorbidly) were ADL limitation (33%), cognitive impairment (9%), and bladder incontinence (8%). Of the syndromes examined at discharge, a higher proportion of patients experienced the following new syndromes at discharge (absent premorbidly): ADL limitation (22%); and bladder incontinence (13%). CONCLUSION: Geriatric syndromes were highly prevalent. Many patients did not return to their premorbid function and acquired new syndromes.

URLhttps://www.ncbi.nlm.nih.gov/pubmed/22092231
DOI10.1111/j.1532-5415.2011.03663.x
Alternate JournalJournal of the American Geriatrics Society