title: [Prognostic value of the primary diagnosis in elderly patients admitted to an acute geriatric unit at discharge and one year later].
abstract: OBJECTIVE
  To analyse the relationship between the primary diagnosis on admission to an Acute Geriatric Unit (AGU) and the risk of hospital mortality and one year after discharge
  
  
  METHODS
  A longitudinal study was conducted on patients admitted to the Central Hospital AGU Red Cross in Madrid in 2009. The admission diagnosis was grouped by Diagnosis Related Groups (DRGs). The date of death was collected from the medical charts and the National Death Index Ministry of Health report. The main outcome of study was the association between diagnoses on admission and functional impairment at discharge (measured as a loss of 10 or more points between the Barthel Index at discharge and that on admission), mortality during hospitalization, at 3 months and one year after discharge. The multivariate analysis was adjusted for age, sex, comorbidity, functional and cognitive status, and serum albumin.
  
  
  RESULTS
  The study included1147 patients, with a mean age of 86.7 years (SD±6.7), and 66% were women. During admission, 10.1% of patients died and 36.6% had functional impairment at discharge. After discharge, 25.5% died at 3 months, and 42.2% at one year. The distribution of the primary diagnoses at admission (between parentheses hospital mortality and at year) were heart failure, 21.4% (8.1% and 37.4%), pneumonia,13.3% (12.3% and 46.4%), and aspiration pneumonia, 4.7% (27.5%, y 71%), respiratory diseases,13.3% (6.6% and 38.2%), urinary infection,10.2% (5.1% and 42.7%), and stroke (excluding AIT), 9.9% (13.3% and 46.9%). In the multivariate analysis, only admissions due to aspiration pneumonia were independently associated with increased risk of hospital mortality (odds ratio, 2.23; 95% CI=1.13 to 44.42), and stroke with increased risk of functional impairment at discharge (odds ratio, 6.01; 95% CI=3.42-10.57). No diagnosis was independently associated with increased risk of death at 3 months and at year
  
  
  CONCLUSIONS
  Admission from aspiration pneumonia carries an increased risk of death in elderly patients hospitalised for acute medical conditions. After discharge, the risk of death must be attributed to factors other than the admission diagnosis.
authors.affiliation: Servicio de Geriatría, Hospital Central Cruz Roja San José y Santa Adela, Madrid, España. Electronic address: jbaztan.hccruzr@salud.madrid.org.
authors.forename: Juan J
authors.initials: JJ
authors.lastname: Baztán Cortés
authors.affiliation: Servicio de Geriatría, Hospital Central Cruz Roja San José y Santa Adela, Madrid, España.
authors.forename: Beatriz
authors.initials: B
authors.lastname: Perdomo Ramírez
authors.affiliation: Servicio de Geriatría, Hospital Central Cruz Roja San José y Santa Adela, Madrid, España.
authors.forename: Alberto
authors.initials: A
authors.lastname: Socorro García
authors.affiliation: Control de Gestión, Hospital Central Cruz Roja San José y Santa Adela, Madrid, España.
authors.forename: Fernando
authors.initials: F
authors.lastname: Álvarez de Abajo
authors.affiliation: Servicio de Geriatría, Hospital Central Cruz Roja San José y Santa Adela, Madrid, España.
authors.forename: Isidoro
authors.initials: I
authors.lastname: Ruipérez Cantera
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006760:Hospitalization; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D010351:Patient Discharge; D011015:Pneumonia, Aspiration / Q000401:mortality*; D011379:Prognosis; D011446:Prospective Studies
keywords: 80 and over; Anciano; Diagnosis; Diagnosis related group; Diagnóstico principal; Grupo relacionado por el diagnóstico; Hospitalisation; Hospitalización; Mortalidad; Mortality