Mortality and complications in very old patients (90+) admitted to departments of internal medicine in Spain.
CONCLUSIONS
Patients over 90 years of age (the "very elderly") account for an increasing number of admissions to departments of internal medicine (IM). The aim of this study was to analyse the demographic data, hospitalization characteristics, medical complications, and predictors of mortality in patients over 90 admitted to IM departments.


METHODS
All patients admitted to IM departments in Spain between the years 2005 and 2007 were analysed. Clinical and demographic data were compared with records from "younger elderly" patients (65-90).


RESULTS
During the study period, there were 1,567,659 patient admissions to IM departments in Spain, and 90,679 (5.8%) were older than 90. Hospital mortality occurred in 22.3% of very elderly patients. The main predictors for hospital death were pressure ulcer (Odds Ratio [OR] 1.55, CI95% 1.45-1.66), thromboembolic disease (OR 1.83, CI95% 1.61-2.09), nosocomial pneumonia (OR 2.53, CI95% 2.39-2.69), hip fracture (OR 2.20, CI95% 1.53-3.18), male gender (OR 1.06, CI95% 1.03-1.10), age (OR 1.05, CI95% 1.04-1.06), dementia (OR 1.13, CI95% 1.08-1.18), cancer (OR 1.60, CI95% 1.51-1.71), acute respiratory failure (OR 1.83, CI95% 1.76-1.89), acute infectious disease (OR 2.30, IC95% 2.11-2.52), and Charlson comorbidity index (OR 1.21, CI95% 1.16-1.26).


CONCLUSIONS
Very elderly patients represent a large and growing fraction of the total admissions to IM departments in Spain. They are at higher risk for complications during their hospital stay and mortality rate is double that of the younger elderly.
Department of Internal Medicine, Hospital Infanta Cristina, Parla, Madrid, Spain. raquel.barba@salud.madrid.org
Raquel
R
Barba
Javier Marco
JM
Martínez
Antonio
A
Zapatero
Susana
S
Plaza
Juan Emilio
JE
Losa
Jesús
J
Canora
Alejandro
A
Pérez
Gonzalo
G
García de Casasola
D017677:Age Distribution; D000369:Aged, 80 and over; D015331:Cohort Studies; D003141:Communicable Diseases / Q000401:mortality; D003428:Cross Infection / Q000401:mortality; D003704:Dementia / Q000401:mortality; D005260:Female; D006620:Hip Fractures / Q000401:mortality; D006748:Hospital Departments / Q000706:statistics & numerical data; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data*; D007388:Internal Medicine / Q000706:statistics & numerical data* / Q000639:trends; D008297:Male; D009369:Neoplasms / Q000401:mortality; D016017:Odds Ratio; D010343:Patient Admission / Q000706:statistics & numerical data* / Q000639:trends; D010351:Patient Discharge / Q000706:statistics & numerical data; D003668:Pressure Ulcer / Q000401:mortality; D012131:Respiratory Insufficiency / Q000401:mortality; D012189:Retrospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D013030:Spain / Q000453:epidemiology; D013923:Thromboembolism / Q000401:mortality