Differential characteristics in polypathological inpatients in internal medicine departments and acute geriatric units: the PLUPAR study.
OBJECTIVE
To determine whether there are any differences between polypathological patients attended in Internal Medicine departments and acute Geriatric units.


METHODS
A cross-sectional multicenter study was performed. Polypathological patients admitted to an internal medicine or geriatrics department and attended by investigators consecutively between March 1 and June 30, 2011 were included. Data of age, sex, living in a nursing residence or at home, diagnostic category, use of chronic medication, Charlson, Barthel and Lawton-Brody indexes, Pfeiffer questionnaire, delirium during last admission, need of a caregiver, and having a caregiver were gathered. The need of a caregiver was defined when the Barthel index was<60 or Pfeiffer questionnaire ≥ 3 errors.


RESULTS
471 polypathological patients, 337 from internal medicine and 144 from geriatrics units were included. Geriatrics inpatients were older and more frequently female. Cardiac (62.1% vs 49.6%; p=.01), digestive (8.3% vs 3.0%; p=.04) and oncohematological diseases (30.2% vs 18.8%; p=.01) were more frequent in patients of internal medicine units and neurological (66.2% vs 40.2%; p<.001) and locomotive ones (39.1% vs 20.4%; p<.001) in geriatrics inpatients. Charlson index was higher for internal medicine inpatients [4.0(2.1) vs 3.5(2.1); p=.04). Patients attended in geriatrics scored higher in Pfeiffer questionnaire [5.5(3.7) vs 3.8(3.3); p<.001], and lower in Barthel [38.8(32.5) vs 61.2(34.3); p=.001] and Lawton-Brody indexes [0.9(1.6) vs 3.0(2.9); p<.001], and more frequently needed a caregiver (87.8% vs 53.6%; p<.001) and had it.


CONCLUSIONS
There are differences in disease profile and functional and cognitive situation between polypathological patients of internal medicine and geriatrics departments.
Internal Medicine Department, Hospital Royo Villanova, Zaragoza, Spain; Comorbidity and polypathology in Aragón research group, Instituto Aragonés de Ciencias de la Salud, Zaragoza, Spain. Electronic address: jdiez@aragon.es.
Jesús
J
Díez-Manglano
Begoña
B
de Escalante Yangüela
Ernesto
E
García-Arilla Calvo
Elena
E
Ubis Díez
Eulalia
E
Munilla López
Mercedes
M
Clerencia Sierra
Paz
P
Revillo Pinilla
Teresa
T
Omiste Sanvicente
D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D005853:Geriatrics; D006748:Hospital Departments / Q000706:statistics & numerical data; D006757:Hospital Units / Q000706:statistics & numerical data; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007388:Internal Medicine; D008297:Male; D017678:Sex Distribution; D013030:Spain
Cognitive impairment; Dependence; Geriatrics; Internal medicine; Multimorbidity; Polypathological patient