Predictors of two-year post-hospitalization mortality among elderly veterans in a study evaluating a geriatric consultation team.
OBJECTIVE
To determine predictors of 2-year post-hospitalization mortality in a cohort of elderly hospitalized patients originally assembled to assess the impact of a Geriatric Consultation Team (GCT).


METHODS
Two-year follow-up of an inception cohort.


METHODS
University-affiliated tertiary care VA Medical Center.


METHODS
One hundred sixty-seven veterans age 75 or older discharged following hospitalization on medical, surgical, or psychiatry services but not intensive care units.


METHODS
None specifically studied here though cohort was previously part of randomized control trial of a Geriatric Consultation Team.


METHODS
Mortality during 2 years of post-hospitalization follow-up.


RESULTS
Two-year post-hospitalization mortality was 28 percent with no difference between the original GCT and control groups. For the entire sample, age, mental status, admission or discharge ADLs (but not change in ADL status), number of admission problems, number of discharge diagnoses, and discharge site were significant predictors of mortality in univariate analysis. Only discharge ADLs and discharge site remained significant in multivariate analysis.


CONCLUSIONS
Measures of ADLs during hospitalization are stronger predictors of mortality following hospitalization than disease diagnoses. Impaired ADLs and placement other than at home are significant predictors of mortality, suggesting that the decision for nursing home placement contains other independently predictive information within it and/or that the subsequent nursing home period produces excess mortality. As had been indicated in short-term follow-up, there was no survival advantage for the Geriatric Consultation Group.
Cohen
H J
HJ
Geriatric Research, Education, and Clinical Center, VA Medical Center, Durham, NC 27705.
Saltz
C C
CC
Samsa
G
G
McVey
L
L
Davis
D
D
Feussner
J R
JR
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005500:Follow-Up Studies; D015577:Geriatric Assessment; D006787:Hospitals, Veterans; D006801:Humans; D008297:Male; D009026:Mortality; D009657:North Carolina; D010351:Patient Discharge; D011237:Predictive Value of Tests; D011379:Prognosis; D012017:Referral and Consultation; D016019:Survival Analysis; D014728:Veterans / Q000706:statistics & numerical data*