Predictors of length of hospital stay among older adults admitted to acute care wards: a multicentre observational study.
BACKGROUND
Reduction in length of hospital stay (LOS) is considered as a potential strategy to optimize resource consumption and reduce health care costs. We analysed predictors of increased LOS among older patients admitted to acute care wards according to type of admission (through the Emergency Room [ER] or elective).


METHODS
We analysed data of 1123 older patients, aged 65years or older, consecutively admitted to seven acute care wards. LOS was defined as the number of days from admission to discharge (or death) and categorized according to its median value (10days).


RESULTS
Mean age of participants was 81±7years and 56% were women. Patients admitted through ER had a shorter LOS compared with those elective (10.4±6.7 vs. 12.0±6.7days; p<0.0001). Factors associated with LOS >10days, for patients admitted through ER, were female gender (OR 0.58; 95% C.I. 0.37-0.90), erythrocyte sedimentation rate (OR 1.02; 95% C.I. 1.01-1.03), and excessive polypharmacy (use of ≥10 drugs during stay) (OR 3.60; 95% C.I. 1.40-9.25). Predictors for elective patients were chronic alcohol consumption (OR 0.54; 95% C.I. 0.32-0.93), walking speed ≥0.8m/s (OR 0.31; 95% C.I. 0.14-0.72), excessive polypharmacy (OR 4.78; 95% C.I. 1.92-11.90), pressure ulcers (OR 2.60; 95% C.I. 1.01-6.79), cerebrovascular disease (OR 0.49; 95% C.I. 0.24-0.99) and dementia (OR 0.18; 95% C.I. 0.08-0.39).


CONCLUSIONS
LOS differed between patients admitted through emergency and through elective admission. Demographic and clinical parameters can affect LOS and polypharmacy was the strongest and the only common risk factor in both groups.
Department of Geriatrics, Orthopaedics and Neurosciences, Catholic University of Sacred Heart, Rome, Italy. Electronic address: davidevetrano@gmail.com.
Davide L
DL
Vetrano
Department of Geriatrics, Orthopaedics and Neurosciences, Catholic University of Sacred Heart, Rome, Italy.
Francesco
F
Landi
Department of Geriatrics, Ghent University Hospital, Ghent, Belgium.
Stefanie L
SL
De Buyser
Department of Geriatrics, Orthopaedics and Neurosciences, Catholic University of Sacred Heart, Rome, Italy.
Angelo
A
Carfì
Emergency Department, Catholic University of Sacred Heart, Rome, Italy.
Giuseppe
G
Zuccalà
Department of Geriatrics, Ghent University Hospital, Ghent, Belgium.
Mirko
M
Petrovic
Department of Medical Sciences, University of Ferrara, Ferrara, Italy.
Stefano
S
Volpato
Geriatrics, Research Hospital of Ancona, IRCCS, Italian National Research Centre on Aging (INRCA), Ancona, Italy.
Antonio
A
Cherubini
Unit of Geriatric Pharmaco-epidemiology, IRCCS, Italian National Research Centre on Aging (INRCA), Cosenza, Italy.
Andrea
A
Corsonello
Department of Geriatrics, Orthopaedics and Neurosciences, Catholic University of Sacred Heart, Rome, Italy.
Roberto
R
Bernabei
Department of Geriatrics, Orthopaedics and Neurosciences, Catholic University of Sacred Heart, Rome, Italy.
Graziano
G
Onder
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000453:epidemiology*; D015992:Body Mass Index; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D050177:Overweight / Q000453:epidemiology*; D010343:Patient Admission / Q000706:statistics & numerical data*; D019338:Polypharmacy; D003668:Pressure Ulcer / Q000453:epidemiology*; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000453:epidemiology*
Elderly; Elective Admission; Emergency admission; Hospitalization; Length of stay; Polypharmacy