Comprehensive geriatric assessment increases 30-day survival in the aged acute medical inpatients.
BACKGROUND
Age and comorbidity are associated with length of stay (LOS) and mortality. Our aim was to compare acutely ill elderly medical patients in geriatric care with general medical care, and to examine the effects of comprehensive geriatric assessment (CGA).


METHODS
In an observational study, we used data from patients aged 80+ years who had been acutely admitted to departments of medicine at Aarhus University Hospital in the period from 1 January 2009 to 31 December 2010. Age, comorbidity and LOS in the Geriatric Department (GD) were compared with those of the general medical departments (MD). A subgroup analysis was made on patients admitted during a 3.5-month period.


RESULTS
A total of 3,877 patients were hospitalized of whom 27% were admitted to the GD. The mean age of the GD patients was 86.9 years versus 85.7 (p < 0.05). Comorbidity was higher in the GD patients than in the MD patients (p < 0.05). No difference was found in LOS. GD patients were hospitalized for median seven days versus median six days in MD patients (β = 1.04 (95% confidence interval (CI): 0.98-1.10)). In the subgroup analysis (n = 496), no differences were shown in 30-day readmission (14% versus 13%) (odds ratio (OR) = 1.08 (95% CI: 0.57-2.02)). Thirty-day mortality in GD patients was lower than in MD patients (6% versus 13%) (OR = 0.40 (95% CI: 0.17-0.92)).


CONCLUSIONS
An acutely ill elderly patient seems to benefit from CGA in a geriatric department. Short-term mortality is reduced despite higher age and comorbidity and the length of stay or readmission rate were not increased.


BACKGROUND
Clinicaltrials.gov - id: CGA-GD-2011
Geriatrisk Afdeling, Aarhus Universitetshospital, P.P. ørumsgade 11, Bygning 7, 8000 Aarhus C, Denmark. meregreg@rm.dk
Merete
M
Gregersen
Anne Birgitte Langsted
AB
Pedersen
Else Marie
EM
Damsgaard
D000208:Acute Disease / Q000401:mortality* / Q000628:therapy*; D000369:Aged, 80 and over; D015897:Comorbidity; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D005260:Female; D015577:Geriatric Assessment; D005853:Geriatrics / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008511:Medicine / Q000706:statistics & numerical data; D016017:Odds Ratio; D010359:Patient Readmission / Q000706:statistics & numerical data; D012189:Retrospective Studies