Clinical and demographic characteristics of elderly patients hospitalised in an internal medicine department in Israel

Abstract

The number of elderly patients hospitalised in acute medical wards is increasing rapidly. It is important to understand the demographic and clinical characteristics of these patients so as to plan appropriate resource allocation and geriatric training programmes. The aim of the study is to describe the demographic and clinical characteristics of elderly patients admitted to an internal medicine department. During a 3-months prospective study, 779 patients over the age of 65 with acute illness admitted to internal medicine wards. The mean age of the patients was 80 +/- 8 years; 277 (36%) were defined as dependent. The latter had significantly more moderate or severe dementia, higher APACH II scores, lower serum albumin levels, needed more mechanical ventilation, a higher mortality rate and more prolonged admissions (for all variables p < 0.001). Infectious disease was the main indication for admission in the dependent patients while in the independent patients it was cardiac disease (54 vs. 29% and 17 vs. 45%, respectively, p < 0.001). In-hospital mortality was 11%. Functional capacity during hospitalisation declined significantly in all patients but more in those over the age of 85. Of those patients discharged from hospital, mental deterioration during the hospitalisation was observed in only 3%. Our study supports the concept of the introduction of specialised geriatric facilities within the general hospital framework, including the geriatric training and education of all residents in internal medicine.