In-hospital elderly mortality and associated factors in 12 Italian acute medical units: findings from an exploratory longitudinal study.


BACKGROUND:Given the progressive demographic ageing of the population and the National Health System reforms affecting care at the bedside, a periodic re-evaluation of in-hospital mortality rates and associated factors is recommended. AIMS:To describe the occurrence of in-hospital mortality among patients admitted to acute medical units and associated factors. Two hypotheses (H) were set as the basis of the study: patients have an increased likelihood to die H1: at the weekend when less nursing care is offered; H2: when they receive nursing care with a skill-mix in favour of Nursing Aides instead of Registered Nurses. METHODS:Secondary analysis of a prospective study of patients >65 years consecutively admitted in 12 Italian medical units. Data on individual and nursing care variables were collected and its association with in-hospital mortality was analysed by stepwise logistic regression analysis. RESULTS:In-hospital mortality occurrence was 6.8 %, and 37 % of the patients died during the weekend. The logistic regression model explained 34.3 % (R 2) of the variance of in-hospital mortality: patients were six times (95 % CI = 3.632-10.794) more likely at risk of dying at weekends; those with one or more AEDs admissions in the last 3 months were also at increased risk of dying (RR 1.360, 95 % CI = 1.024-1.806) as well as those receiving more care from family carers (RR = 1.017, 95 % CI = 1.009-1.025). At the nursing care level, those patient receiving less care by RNs at weekends were at increased risk of dying (RR = 2.236, 95 % CI = 1.270-3.937) while those receiving a higher skill-mix, thus indicating that more nursing care was offered by RNs instead of NAs were at less risk of dying (RR = 0.940, 95 % CI = 0.912-0.969). CONCLUSIONS:Within the limitations of this secondary analysis, in addition to the role of some clinical factors, findings suggest redesigning acute care at weekends ensuring consistent care both at the hospital and at the nursing care levels.


Aging Clin Exp Res


Ambrosi E,De Togni S,Guarnier A,Barelli P,Zambiasi P,Allegrini E,Bazoli L,Casson P,Marin M,Padovan M,Picogna M,Taddia P,Salmaso D,Chiari P,Frison T,Marognolli O,Canzan F,Saiani L,Palese A




Has Abstract


2017-06-01 00:00:00














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    abstract:BACKGROUND:The aging trajectory from a state of robustness and good health proceeds from sarcopenia to frailty followed by disability and death due to decline in skeletal muscle mass and function. Sarcopenia is now formally recognized as a muscle disease with an ICD-10-MC diagnosis code. The autophagic response seems t...

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    abstract::Finding a biomarker of long length-of-stay (LOS) would provide a simple solution to target frail older inpatients at such risk. The aim of this study was to determine whether serum 25-hydroxyvitamin D (25OHD) deficiency, defined as serum concentration <25 nmol/L, was associated with long LOS among inpatients admitted ...

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    authors: Beauchet O,Launay CP,Maunoury F,de Decker L,Fantino B,Annweiler C

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    abstract:BACKGROUND:Most studies on atrial fibrillation (AF) epidemiology, treatment, and outcomes have included mainly Caucasians patients. The world literature on AF in other ethnicities is very limited particularly in the elderly. AIMS:The aim of this study was to compare the clinical characteristics, treatment and outcome ...

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    authors: Salam AM,AlBinali HA,Al-Sulaiti EM,Al-Mulla AW,Singh R,Al Suwaidi J

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  • Predictive value of C-reactive protein and NT-pro-BNP levels in sepsis patients older than 75 years: a prospective, observational study.

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    authors: Li H,Shan-Shan Z,Jian-Qiang K,Ling Y,Fang L

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  • Effectiveness of individualized fall prevention program in geriatric rehabilitation hospital setting: a cluster randomized trial.

    abstract:BACKGROUND AND AIMS:There is no conclusive evidence that hospital fall prevention programs can reduce the number of falls. We aimed to investigate the effect of a targeted individualized falls prevention program in a geriatric rehabilitation hospital. METHODS:This was a two-stage cluster-controlled trial carried out i...

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    authors: Aizen E,Lutsyk G,Wainer L,Carmeli S

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  • Stepping down backwards as a means of detecting biomechanical differences between healthy older and younger adults.

    abstract:BACKGROUND AND AIMS:Changes in sensory- motor systems that occur with age result in a decrease in postural equilibrium, which has been linked with an increased risk of falling in the elderly. Stepping down backwards from a step perturbs dynamic postural equilibrium, thus offering an opportunity to analyze the biomechan...

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    authors: Michel-Pellegrino V,Hewson D,Hogrel JY,Duchêne J

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    authors: Soudry E,Preis M,Hod R,Hamzany Y,Hadar T,Bahar G,Sternov Y,Shpitzer T

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    authors: Laessoe U,Voigt M

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    authors: Gatto S,Gimigliano F,Gimigliano R,Iolascon G

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    authors: Grahn Kronhed AC,Blomberg C,Löfman O,Timpka T,Möller M

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    authors: Fox J,Garber P,Hoffman M,Johnson D,Schaefer P,Vien J,Zeaton C,Thompson LV

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    authors: Frändin K,Borell L,Grönstedt H,Bergland A,Helbostad JL,Puggaard L,Andresen M,Granbo R,Hellström K

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    authors: Iavarone A,Milan G,Vargas G,Lamenza F,De Falco C,Gallotta G,Postiglione A

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    journal_title:Aging clinical and experimental research

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    pub_type: 杂志文章


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    journal_title:Aging clinical and experimental research

    pub_type: 杂志文章


    authors: Seynnes O,Hue O,Ledrole D,Bernard PL

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    journal_title:Aging clinical and experimental research

    pub_type: 杂志文章


    authors: Athauda D,Batley R,Ellis C

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    journal_title:Aging clinical and experimental research

    pub_type: 杂志文章


    authors: Lange-Maia BS,Newman AB,Strotmeyer ES,Harris TB,Caserotti P,Glynn NW

    更新日期:2015-06-01 00:00:00

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    journal_title:Aging clinical and experimental research

    pub_type: 杂志文章


    authors: Losi G,Gomez-Gonzalo M,Zonta M,Chiavegato A,Carmignoto G

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    journal_title:Aging clinical and experimental research

    pub_type: 杂志文章,多中心研究


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