[Unexpectedly high mortality rate after acute hospital admission of elderly patients without a medical history].
OBJECTIVE
To determine whether having no medical history is a favourable or unfavourable predictor of the relative risk of post-admission mortality for elderly patients acutely admitted to hospital.


METHODS
Descriptive, retrospective.


METHODS
The records of all patients > or = 75 years old who were acutely admitted to the Department of Internal Medicine at the Amsterdam Academic Medical Centre between 1 January 1998 and 31 December 1999 were studied. Age, sex, complete medical history, admission diagnosis, and survival status at discharge were registered.


RESULTS
Of the 460 patients studied (201 men and 259 women; age: 74-100 years; median: 82), 25 (5.4%) had no medical history. The total admission-related mortality was 17% (80/460). Patients with no medical history had a mortality rate of 48% (12/25) and patients with a medical history a mortality rate of 16% (68/435). Therefore the difference in mortality rate was 32% (95% CI: 14-51; p = 0.001) to the detriment of patients without a medical history. The age and sex-adjusted odds ratio for mortality associated with having no medical history was 4.0 (95% CI: 1.7-9.4).


CONCLUSIONS
It seems that not having a medical history is an unfavourable prognostic sign for acutely admitted elderly patients.
Smulders
Y M
YM
Academisch Medisch Centrum/Universiteit van Amsterdam, afd. Inwendige Geneeskunde, Amsterdam. y.smulders@vumc.nl
D000208:Acute Disease / Q000401:mortality*; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D017052:Hospital Mortality; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008487:Medical History Taking; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis