title: Five-year survival and prognostic factors in a cohort of hospitalized nonagenarians.
abstract: BACKGROUND
  The number of hospitalized nonagenarians is increasing. Only a few studies have evaluated long-term predictors of survival in these patients. The aim of this study was to determine the 5-year outcome of a cohort of hospitalized nonagenarians, and to identify predictors of long-term survival.
  
  
  METHODS
  In 124 consecutive medical hospitalized patients older than 89 years, and followed up during 5 years, the following variables were prospectively recorded: sociodemographic characteristics, main diagnoses, Charlson comorbidity index, Barthel index, Lawton-Brody test, Mini-Mental State Examination, Short Portable Mental Status Questionnaire of Pfeiffer, Mini Nutritional Assessment, albumin levels, and the 5-year survival.
  
  
  RESULTS
  Out of the 124 patients, 109 died (87.9%) during the follow-up. The probability of being alive at 1, 3 and 5 years was 45%, 22% and 12%, respectively. A worse 5-year survival was significantly related to the diagnoses of pneumonia (p=0.037), heart failure (p=0.045), higher Charlson index (p=0.026), poorer functional status measured by the Barthel index (p=0.003), and the Lawton-Brody test (p=0.007), cognitive impairment measured by the Pfeiffer test (p=0.011), and lower levels of albumin (p=0.028). In the multivariate analysis, the Charlson index (p<0.001), and the Barthel index (p=0.003) were independently related to 5-year survival. These two variables were also 5-year survival prognostic factors in the subgroup of discharged patients. A prognostic index using these two variables was created: PI=(0.2 × Charlson index + 0.6 × Barthel index) × 0.92.
  
  
  CONCLUSIONS
  In hospitalized nonagenarian patients, poor scores in the Barthel Index and a higher comorbidity evaluated by the Charlson index are independently related to 5-year survival.
authors.affiliation: Internal Medicine Department, University Hospital of Gran Canaria Dr. Negrin. Bco. La Ballena s/n. 35010, Las Palmas, Spain. acondemar@telefonica.net
authors.forename: Alicia
authors.initials: A
authors.lastname: Conde-Martel
authors.forename: Marion
authors.initials: M
authors.lastname: Hemmersbach-Miller
authors.forename: Joaquin
authors.initials: J
authors.lastname: Marchena-Gomez
authors.forename: Pedro
authors.initials: P
authors.lastname: Saavedra-Santana
authors.forename: Pedro
authors.initials: P
authors.lastname: Betancor-Leon
mesh_terms: D000203:Activities of Daily Living; D000369:Aged, 80 and over; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D015577:Geriatric Assessment / Q000706:statistics & numerical data; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data*; D008137:Longitudinal Studies; D008297:Male; D015999:Multivariate Analysis; D009752:Nutritional Status; D011379:Prognosis; D012307:Risk Factors; D016019:Survival Analysis