We investigated the relationship between frailty and atypical disease presentation in predicting adverse hospital outcomes and complications of the hospital course of elderly patients admitted to general medical services.
We conducted a cohort study in a large (800 beds) tertiary care university hospital.
Patients were classified as being well or frail on the basis of the premorbid Barthel Index (well, score of =95 [n=76] ; frail, score of =95 [n=117]). Frail elderly were older (80 vs 76 years), more often female (62% vs 46%), and less likely to be community dwelling (89% vs 99%). Atypical disease presentation was more common in the frail elderly (59% vs 25% ; P<. 001).
Of those who presented atypically, the frail most often presented with delirium (61%) and the well presented with falls (37%) and delirium (32%). Of the frail elderly with atypical symptoms, 60% had adverse hospital outcomes compared with 32% of the well elderly who presented typically (P<. 05).
Logistic regression analysis showed that premorbid functional dependence (odds ratio, 2.48 ; 95% confidence interval, 1.17 to 5.22), atypical disease presentation (odds ratio, 2.37 ; 95% confidence interval, 1.20 to 4.67), and functional decline at admission (odds ratio, 5,64 ; 95% confidence interval, 2.37 to 13,44) were all independently predictive of poor hospital outcomes.
Mots-clés Pascal : Influence, Fragilité, Santé, Symptomatologie, Atypique, Evolution, Etude comparative, Vieillard, Homme, Gérontologie
Mots-clés Pascal anglais : Influence, Brittleness, Health, Symptomatology, Atypical, Evolution, Comparative study, Elderly, Human, Gerontology
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Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 95-0338128
Code Inist : 002B30A03B. Création : 01/03/1996.