title: A prospective, multidimensional follow-up study of a geriatric hospitalised population: predictors of discharge and well-being.
abstract: OBJECTIVE
  Ageing trends in populations are common amongst most European countries. One of the consequences of this trend is the increase of hospitalisation of elderly patients. To better manage the elderly population hospitalisation, it is crucial to obtain a better understanding of this population's clinical and functional conditions and their hospitalisation outcome predictors. The present prospective observational cohort study aimed at studying the variables considered predictive of the length of stay, of destination at discharge, of re-hospitalisation, and of mortality at 6 months of elderly (age >64 years, N = 329) admitted to ten geriatric units, having different missions (e.g., cognitive impairment and dementia; movement disorders; bone fractures and immobilisation syndrome; or stroke), of the St. John of God Order during a 4-month-long index period.
  
  
  METHODS
  The patients were monitored from the first day of hospitalisation through the discharge. Researchers filled in a "Patient Schedule" based on a comprehensive set of socio-demographic and clinical variables and standardised assessment tools. We used a standardised telephone interview to re-assess patients at the 6-month follow-up.
  
  
  RESULTS
  The BRASS score proved to be a better reliable predictor of length of stay (F = 3.9, p = 0.04) among all variables associated with higher risks of prolonged hospital stay and post-discharge problems. In addition, discharge destination was also predicted by the use of the Tinetti Scale score (OR = 0.95, 95 % CI 0.90-0.99), the Mini Mental State Examination (MMSE) score (OR = 0.1.07, 95 % CI 1.01-1.13) and by independence in daily activity as measured by the IADL scale (OR = 4.09, 95 % CI 1.46-11.44). Motor functioning resulted as a reliable predictor (OR = 2.67, 95 % CI 1.27-5.59) of re-hospitalisation in all the medical units. Lastly, female gender (OR = 0.28, 95 % CI 0.11-0.71) resulted as the only reliable variable associated with a lower mortality risk after discharge.
  
  
  CONCLUSIONS
  The variables related to the clinical and functional status were reliable predictors for length of stay, for discharge destination, and for re-hospitalisation among older patients admitted to ten geriatric units in Italy. Further research is needed to establish valid and reliable predictors of mortality risk, to develop effective preventive strategies in those vulnerable populations.
authors.affiliation: IRCCS Centro San Giovanni di Dio, Fatebenefratelli, Via Pilastroni 4, Brescia, Italy, jdagani@fatebenefratelli.it.
authors.forename: Jessica
authors.initials: J
authors.lastname: Dagani
authors.forename: Clarissa
authors.initials: C
authors.lastname: Ferrari
authors.forename: Maria Elena
authors.initials: ME
authors.lastname: Boero
authors.forename: Cristina
authors.initials: C
authors.lastname: Geroldi
authors.forename: Gian Marco
authors.initials: GM
authors.lastname: Giobbio
authors.forename: Paolo
authors.initials: P
authors.lastname: Maggi
authors.forename: Anna Lucia
authors.initials: AL
authors.lastname: Melegari
authors.forename: Guido
authors.initials: G
authors.lastname: Sattin
authors.forename: Matteo
authors.initials: M
authors.lastname: Signorini
authors.forename: Daniele
authors.initials: D
authors.lastname: Volpe
authors.forename: Orazio
authors.initials: O
authors.lastname: Zanetti
authors.forename: Giovanni
authors.initials: G
authors.lastname: de Girolamo
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D015577:Geriatric Assessment; D006760:Hospitalization; D006801:Humans; D007902:Length of Stay; D008137:Longitudinal Studies; D008297:Male; D010351:Patient Discharge; D011446:Prospective Studies