Illness presentation in elderly patients.
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
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 95-0338128
Code Inist : 002B30A03B. Création : 01/03/1996.