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. 2025 Jul 25;37(1):231.
doi: 10.1007/s40520-025-03125-1.

Factors associated with hospitalization from a geriatric short-stay unit (OBI-GER): a retrospective cohort study

Laura Orlandini  1 , Benedetta Maisano  2 , Alice Margherita Ornago  3 , Elena Pinardi  2   3 , Alberto Finazzi  2 , Andrea Bonini  2 , Maurizio Corsi  4 , Giacomo Mosca  5 , Ernesto Contro  5 , Andrea Staglianò  4 , Martina Manna  2 , Antonio Piscitelli  6 , Aida Andreassi  6 , Maria Cristina Ferrara  2 , Chukwuma Okoye  4   2 , Giuseppe Bellelli  4   2
Affiliations

Factors associated with hospitalization from a geriatric short-stay unit (OBI-GER): a retrospective cohort study

Laura Orlandini et al. Aging Clin Exp Res. .

Abstract

Background: Geriatric Short-Stay Observation Units (G-SSU) are specialized units designed to improve care for older adults within the emergency department (ED). At our hospital, the Osservazione Breve Intensiva Geriatrica (OBI-GER) was established as a dedicated G-SSU.

Aims: This study aims to characterize the clinical profile of older adults admitted to OBI-GER and identify factors associated with hospitalization within the first 24 h of admission.

Methods: Retrospective, single-center study including individuals aged ≥ 75 years, admitted to OBI-GER between August 2023 and August 2024, with frailty and/or delirium during ED stay. Multivariable logistic regression model with stepwise selection was used to assess associations between hospitalization and clinical, functional, laboratory, and organizational variables.

Results: Overall, 353 patients (mean age 86.8 ± 5.5 years, 47.9% male) were included, of whom 109 (30.8%) required hospitalization. The cohort exhibited moderate frailty (median Clinical Frailty Scale = 6, IQR 6-7) and a considerable comorbidity burden (median Charlson Comorbidity Index [CCI] = 6, IQR 5-8), along with a high prevalence of dementia (45%) and polypharmacy (mean 7.1 ± 3.4 medications). Independent risk factors for hospitalization included higher CCI (OR 1.19, 95% CI 1.05-1.35), delirium on the first day of OBI-GER (OR 2.03, 95% CI 1.13-3.64), frequent faller profile (OR 2.66; 95% CI 1.38-5.12), and lower hemoglobin levels at ED admission (OR 0.89, 95% CI 0.79-0.99).

Conclusions: Despite their clinical complexity, only one-third of patients admitted to OBI-GER required hospitalization. CCI, delirium, fall history, and hemoglobin levels may serve to stratify hospitalization risk and optimize patient selection for G-SSU.

Keywords: Comprehensive geriatric assessment; Frailty; Geriatric emergency medicine; Older adults; Short-stay unit.

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Conflict of interest statement

Declarations. Ethics approval: This study was performed in line with the principles of the Declaration of Helsinki. The local Ethics Committee (deliberation no. 1205, December 14, 2022) authorized data collection and its use as part of a clinical registry. Informed consent: Informed consent was obtained from all individual participants or their next of kin when patients were not able to provide consent. Conflict of interest: The authors have no competing interests to declare that are relevant to the content of this article.

Figures

Fig. 1
Fig. 1
Study Flowchart. Legend: Multiple exclusion criteria may apply to the same individual
Fig. 2
Fig. 2
Presenting symptoms at ED admission, ordered by frequency within patients discharged or hospitalized from OBI-GER
Fig. 3
Fig. 3
Multivariable Logistic Regression Analysis: Full Model (panel A) and Stepwise Selection Model (panel B). OR = Odds Ratio; CI = confidence interval; CCI = Charlson Comorbidity Index, without age CFS = Clinical Frailty Scale; G-SSU = Geriatric Short Stay Unit; CGA = Comprehensive Geriatric Assessment; NEWS2 = national early warning score 2; Hb = Hemoglobin; WBC = White Blood Count; CRP = C Reactive Protein. Note: early CGA refers to CGA completion within 24 h from OBI-GER admission
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