title: Short- and long-term outcomes of older patients in intermediate care units.
abstract: OBJECTIVE
  To evaluate short- and long-term outcomes of elderly patients (>or=65 years) treated at an intermediate care unit (IMCU) and to identify outcome predictors.
  
  
  METHODS
  Prospective observational study in the IMCU of a university teaching hospital.
  
  
  METHODS
  We studied 412 patients over 8 months, classified into three groups: under 65years (control group, n=158), 65-80 (n=186), and >80 (n=68).
  
  
  METHODS
  At admission: APACHE II, TISS-28 first day, Charlson Index, diagnosis, and prior Barthel Index.
  
  
  METHODS
  in-hospital mortality, length of stay, discharge destination, and 2-year mortality and readmissions. Data analysis included multivariate logistic regression and receiver operating characteristics area under the curve (ROC AUC).
  
  
  RESULTS
  No statistically significant differences between groups were observed in hospital mortality (14.1%), discharge to a long-term facility (2.7%), or 2-year readmissions (1.2+/-2.1). However, hospital stay was longer in patients aged 65-80years (14 vs.10 days) and 2-year mortality was higher in those 65 or over (34% vs.10.6%). In the overall series in-hospital mortality was predicted by APACHE II, first-day TISS-28, and diagnosis (ROC AUC 0.81), and 2-year mortality by Charlson Index and age (ROC AUC 0.77). In the elderly patients 2-year mortality was predicted by Charlson and Barthel indices (ROC AUC 0.70).
  
  
  CONCLUSIONS
  Illness severity and therapeutic intervention at admission to IMCU were predictors of short-term mortality, whereas the strongest predictor of long-term mortality was comorbidity. Our results suggest that comprehensive assessment of elderly patients at admission to IMCUs may improve outcome prediction.
authors.affiliation: Department of Internal Medicine and Emergencies, Division of Geriatrics, Hospital de la Santa Creu i Sant Pau, Autonomous University of Barcelona, Mas Casanovas 90, 08025 Barcelona, Spain. otorres@hsp.santpau.es
authors.forename: Olga H
authors.initials: OH
authors.lastname: Torres
authors.forename: Esther
authors.initials: E
authors.lastname: Francia
authors.forename: Vanesa
authors.initials: V
authors.lastname: Longobardi
authors.forename: Ignasi
authors.initials: I
authors.lastname: Gich
authors.forename: Salvador
authors.initials: S
authors.lastname: Benito
authors.forename: Domingo
authors.initials: D
authors.lastname: Ruiz
mesh_terms: D018806:APACHE; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007380:Intermediate Care Facilities / Q000706:statistics & numerical data*; D007902:Length of Stay / Q000706:statistics & numerical data; D016015:Logistic Models; D008297:Male; D017063:Outcome Assessment, Health Care; D010359:Patient Readmission / Q000706:statistics & numerical data; D011446:Prospective Studies; D012372:ROC Curve; D013030:Spain / Q000453:epidemiology; D016019:Survival Analysis