Functional decline among elderly patients admitted for different illnesses: A cohort study
Journal
International Journal of Clinical and Experimental Medicine
Journal Volume
9
Journal Issue
6
Pages
11942-11949
Date Issued
2016
Author(s)
Abstract
Background: Elderly who survive after acute insults are frequently left with intractable complications and multimorbidity. Episodes of hospitalization frequently cause physical limitations among these patients, but illness-specific estimates of functional decline are unclear. Methods: We utilized a prospectively collected cohort of elderly patients (? 65) admitted to the general medical wards between January 2014 and August 2014, for analysis. All participants completed questionnaires about clinical features, comorbidity profiles, and pre-morbid functional status, estimated by Barthel Index (BI) on admission. Dedicated nurse practitioners assessed BI on admission and at discharge for enrollees, and the results were analyzed according to their main admission diagnostic categories. Results: We recruited one hundred and fifty-two elderly patients (mean, 80.4 years; 51% male), among whom 55% had hypertension and 39% had diabetes. They were admitted mainly for pulmonary disorders (46%), followed by sepsis of unknown origin (11%), gastrointestinal (10%) and renal (10%) disorders, hepatobiliary (7%) and oncology disorders (7%). Elderly patients admitted for renal and pulmonary disorders had significantly lower pre-morbid BI scores, while those admitted for oncology, gastrointestinal, and neuropsychiatric disorders demonstrated more significant functional decline compared with patients admitted for other disorders (BI scores for oncology, 48.3 ± 23.6; for gastrointestinal, 48.3 ± 28.4; for neuropsychiatric, 57.5 ± 29). Conclusion: We discovered that elderly suffered from different types of illnesses might display variable degrees of functional decline on admission compared to their premorbid status. Rehabilitation programs focusing on those with neuropsychiatric disorders on admission might improve functional outcomes. ? 2016, E-Century Publishing Corporation. All rights reserved.
Subjects
Barthel index; Elderly; Functional status; Geriatrics
SDGs
Other Subjects
aged; Article; asthma; Barthel index; chronic kidney disease; chronic obstructive lung disease; comorbidity assessment; coronary artery disease; dementia; diabetes mellitus; elderly care; female; functional status; functional status assessment; gastrointestinal hemorrhage; glomerulus filtration rate; heart failure; human; hypertension; liver cirrhosis; lung disease; major clinical study; male; neoplasm; neuropsychiatry; parkinsonism; peripheral occlusive artery disease; pneumonia; public health; questionnaire; respiratory failure; sepsis; very elderly
Publisher
E-Century Publishing Corporation
Type
journal article