Short-term mortality and associated factors among older hospitalized patients: A narrative retrospective analysis of end-of-life care in an acute geriatric unit

Abstract

Objectives: To explore short-term mortality and its predictors among older patients hospitalized in a acute geriatric ward (AGW) in Northwestern Italy.

Design: Retrospective observational single-center cohort study.

Material and methods: Patients consecutively admitted for any reason between June 2021 and May 2022 were included in the analysis. Along with sociodemographic, clinical, and functional variables, prognosis estimation (Palliative Prognostic Index; PPI) at the time of admission was registered. Short-term all-cause mortality (in-hospital and within 3 months of discharge) was the primary outcome.

Results: About one-third of the total sample died in the short-term (32.4 %). Along with PPI score (OR 1.115, 95 %CI 1.034-1.202), short-term mortality was independently associated with functional dependency (OR 1.278, 95 %CI 1.170-1.395).

Conclusions: The high short-term mortality in our sample should call for the inclusion of palliative prognostic tools within the in-hospital comprehensive geriatric assessment to better recognize and appropriately manage older patients at the end of life.

Keywords: Frailty; Geriatric assessment; Hospital mortality; Palliative care.