title: Comparison of a geriatric unit with a general ward in Mexican elders.
abstract: There is evidence that geriatric services may be more effective in handling problems of the elderly in acute care. We therefore studied a cohort of matched triplets (age, gender and admission diagnosis), to assess the effect of a geriatric service on elderly problems (falls, pressure ulcers, delirium and functional decline). This is a follow up study; comparing a geriatric unit with an internal medicine unit at two hospitals of the Mexican Institute of Social Security (IMSS) in Mexico City. Socio-demographic characteristics, functionality, emotional state, cognitive status, delirium, co-morbidities, diagnosis, number of medications, presence of pressure ulcers and falls, were assessed. We developed a composite variable as a global end-point, including: delirium, falls, mortality, pressure sores and functional decline. 70 patients were included in the geriatric services and 140 in the internal medicine unit. Mean age =72.5±7 years (±S.D.), and 52.9% were women. At baseline, only illiteracy, quality of life and the number of medications were statistically different between each group. Fully adjusted multiple logistic conditional regression model found an odds ratio of 0.27 (95% CI 0.1-0.7) for the presence of the composite variable, favoring the geriatric unit. Geriatric units in acute care may be beneficial in different frequent end points in elderly.
authors.affiliation: Instituto de Geriatría, Secretaría de Salud, Periférico Sur 2767, Colonia San Jerónimo Lídice, Delegación Magdalena Contreras, CP 10200, Mexico City, Mexico.
authors.forename: Mario Ulises
authors.initials: MU
authors.lastname: Pérez-Zepeda
authors.forename: Luis Miguel
authors.initials: LM
authors.lastname: Gutiérez-Robledo
authors.forename: Sergio
authors.initials: S
authors.lastname: Sánchez-Garcia
authors.forename: Teresa
authors.initials: T
authors.lastname: Juárez-Cedillo
authors.forename: Jose Juan García
authors.initials: JJ
authors.lastname: Gonzalez
authors.forename: Francisco
authors.initials: F
authors.lastname: Franco-Marina
authors.forename: Carmen
authors.initials: C
authors.lastname: García-Peña
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data; D000368:Aged; D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D015577:Geriatric Assessment / Q000706:statistics & numerical data; D006299:Health Services for the Aged; D006757:Hospital Units; D006801:Humans; D015994:Incidence; D008297:Male; D008800:Mexico; D008875:Middle Aged; D010362:Patients' Rooms; D003668:Pressure Ulcer / Q000453:epidemiology; D015995:Prevalence; D011788:Quality of Life