title: [Early indicators of prolonged hospitalization of the elderly: pilot study at Strasbourg University Hospital].
abstract: OBJECTIVE
  The aim of this study was to identify early indicators of prolonged hospital stays by elderly patients.
  
  
  METHODS
  This prospective pilot study, conducted at Strasbourg University Hospital, included patients aged 75 years or older who were hospitalized via the emergency department (SAFES cohort: Sujet Agé Fragile: Evaluation et suivi, that is, Frail Elderly Subjects: Evaluation and Follow-up). A gerontologic evaluation of these patients during the first week of their hospitalization furnished the data for an exact logistic regression. Two definitions were used for prolonged hospitalization: 30 days and a composite number adjusted for diagnosis-related group according to the French classification (f-DRG).
  
  
  RESULTS
  The analysis examined 137 hospitalizations. More than two thirds of the patients were women (73%), with a mean age of 84 years. Twenty-four hospitalizations (17%) lasted more than 30 days, but only 6 (4%) lasted beyond the DRG-adjusted limit. No social or demographic variables appeared to affect the length of stay, regardless of the definition of prolonged stay. No indicator was associated with the 30-day limit, but clinical markers were linked to prolongation assessed by f-DRG adjustment. A "risk of malnutrition" (OR=14.07) and "mood disorders" (OR=2,5) were both early markers for prolonged hospitalization. Although not statistically significant, "walking difficulties" (OR=2.72) and "cognitive impairment" (OR=5.03) appeared to be associated with prolonged stays. No association was seen with either the variables measured by Katz's Activities of Daily Living Index or its course during hospitalization.
  
  
  CONCLUSIONS
  Our study shows that when generally recognized indicators of frailty are taken into account, a set of simple items enables a predictive approach to the prolongation of emergency hospitalizations of the elderly.
authors.affiliation: Département de Réhabilitation et Gériatrie, Hôpital des Trois-Chêne, Hôpitaux universitaires de Genève, Thonex-Genève, Suisse. Pierre.O.Lang@hcuge.ch
authors.forename: Pierre-Olivier
authors.initials: PO
authors.lastname: Lang
authors.forename: Damien
authors.initials: D
authors.lastname: Heitz
authors.forename: Nicolas
authors.initials: N
authors.lastname: Meyer
authors.forename: Moustapha
authors.initials: M
authors.lastname: Dramé
authors.forename: Nicolas
authors.initials: N
authors.lastname: Jovenin
authors.forename: Joël
authors.initials: J
authors.lastname: Ankri
authors.forename: Dominique
authors.initials: D
authors.lastname: Somme
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Novella
authors.forename: Jean-Bernard
authors.initials: JB
authors.lastname: Gauvain
authors.forename: Alain
authors.initials: A
authors.lastname: Colvez
authors.forename: Pascal
authors.initials: P
authors.lastname: Couturier
authors.forename: Isabelle
authors.initials: I
authors.lastname: Lanièce
authors.forename: Thierry
authors.initials: T
authors.lastname: Voisin
authors.forename: Benoit
authors.initials: B
authors.lastname: de Wazières
authors.forename: Régis
authors.initials: R
authors.lastname: Gonthier
authors.forename: Claude
authors.initials: C
authors.lastname: Jeandel
authors.forename: Damien
authors.initials: D
authors.lastname: Jolly
authors.forename: Olivier
authors.initials: O
authors.lastname: Saint-Jean
authors.forename: François
authors.initials: F
authors.lastname: Blanchard
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003072:Cognition Disorders; D015331:Cohort Studies; D003953:Diagnosis-Related Groups; D005260:Female; D005500:Follow-Up Studies; D016330:Frail Elderly; D015577:Geriatric Assessment; D006801:Humans; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D010865:Pilot Projects; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors; D012959:Socioeconomic Factors; D016138:Walking