Skip to main content
Log in

Multidimensional assessment and risk factors for prolonged hospitalization in the elderly

  • Original Articles
  • Published:
Aging Clinical and Experimental Research Aims and scope Submit manuscript

Abstract

Background and aims: Frailty, multiple pathologies, functional impairment and socioeconomic conditions can prolong the length of hospitalization in the elderly. The aim of our study was to analyze risk factors for prolonged hospitalization. Methods: Our sample included 1054 patients consecutively admitted to the University Department of Geriatric Medicine of Torino, Italy. We examined some demographic variables (age, sex, socioeconomic conditions), affective, cognitive and functional status, main pathologies, and blood pressure and some hematological parameters (hemoglobin, creatinine, albumin, sodium). Results: The number of functions lost to IADL and ADL, DMI (Dependent Medical Index) dependence, high levels of creatinine and low blood levels of albumin and sodium were associated with longer hospitalization, as also were the following clinical diagnoses: tumor, chronic obstructive pulmonary disease (COPD), hip fractures, peripheral arterial disease (PAD), and pressure sores. Independent predictors of prolonged hospitalization were: the number of functions lost to the ADL index, pressure sores, hip fracture, peripheral arterial disease with critical ischemia, and low levels of sodium. Conclusions: Multidimensional assessment is essential to identify medical, functional and socioeconomic problems, and can highlight risk factors for prolonged hospitalization.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Rich M, Keller A, Schechtman K, Marshall W, Kouchoukos N. Increased complications and prolonged hospital stay in elderly cardiac surgical patients with low serum albumin. Am J Cardiol 1989; 63: 714–8.

    Article  PubMed  CAS  Google Scholar 

  2. Herrmann F, Safran C, Levkoff S, Minaker K. Serum albumin level on admission as predictor of death, length of stay, and readmission. Arch Intern Med 1992; 152: 125–30.

    Article  PubMed  CAS  Google Scholar 

  3. Masotti L, Ceccarelli E, Cappelli R, Barabesi L, Guerrini M, Forconi S. Length of hospitalization in elderly patients with community-acquired pneumonia. Aging Clin Exp Res 2000; 12: 35–41.

    CAS  Google Scholar 

  4. Thomas R, Cameron D, Fahs MA. Prospective study of delirium and prolonged hospital stay. Exploratory study. Arch Gen Psychiatry 1988; 45: 937–40.

    Article  CAS  Google Scholar 

  5. Incalzi RA, Pedone C, Onder G, Pahor M, Carbonin PU, for the GIFA (Italian Group for Pharmacological Survey in the Elderly). Predicting length of stay of older patients with exacerbated chronic obstructive pulmonary disease. Aging Clin Exp Res 2001; 13: 49–57.

    CAS  Google Scholar 

  6. Garcia Segura A, Gadea Ruiz C, Olive Fanlo B, et al. Hyponatremia upon admission in patients over 65 years of age. Relation with medium length of stay and hospital mortality. An Med Interna 1996; 13: 616–7.

    Google Scholar 

  7. Maguire P, Taylor I, Stout R. Elderly patients in acute medical wards: factors predicting length of stay in hospital. BMJ 1986; 292: 1251–3.

    Article  PubMed  CAS  Google Scholar 

  8. Brock K, Robinson P, Simondson J, Goldie P, Nosworthy J, Greenwood K. Prediction of length of hospital stay following stroke. J Qual Clin Pract 1997; 17: 37–46.

    PubMed  CAS  Google Scholar 

  9. Greene E, Cunningham C, Eustace A, Kidd N, Clare A, Lawlor B. Recurrent falls are associated to increased length of stay in elderly psychiatric inpatients. Int J Geriatr Psychiatry 2001; 16: 965–8.

    Article  PubMed  CAS  Google Scholar 

  10. Zanocchi M, Ponzetto M, Neirotti M, Maero B, Francisetti F, Fabris F. Variabili predittive di mortalità negli anziani dopo ricovero ospedaliero. L’importanza della valutazione multidimensionale. Rec Prog in Medicina 2001; 92: 184–8.

    CAS  Google Scholar 

  11. Epstein A, Stern R, Tognetti J, et al. The association of patient’s socioeconomic charateristics with the length of hospital stay and hospital charges within diagnosis-related groups. N Engl J Med 1988; 318: 1579–85.

    Article  PubMed  CAS  Google Scholar 

  12. Lawton MP, Brody EM. Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist 1969; 9: 179–86.

    Article  PubMed  CAS  Google Scholar 

  13. Katz S, Downs TD, Cash HR, Grotz RC. Progress in development of the index of ADL. Gerontologist 1970; 1: 20–30.

    Article  Google Scholar 

  14. Pfeiffer EA. Short portable mental status questionnaire for the assessment of organic brain deficit in elderly patients. J Am Geriatr Soc 1975; 23: 33–7.

    Google Scholar 

  15. Yesavage JA, Brink TL, Rose TL, et al. Development and validation of a geriatric depression screening scale. A preliminary report. J Psychiatr Res 1983; 17: 37–49.

    Article  CAS  Google Scholar 

  16. Fabris F, Molaschi M, Ponzetto M, Fonte G, Visentin P, Scarafiotti C. Dependence Medical Index (DMI) in elderly persons: a tool for identification of dependence for medical reasons. BOLD 1996; 2: 9–12.

    Google Scholar 

  17. US Department of Health and Human Services. The international classification of disease. 9th revision, clinical modification: ICD-9-CM. 3rd ed. Washington DC: US Public Health Services Publication PHS, 1989.

    Google Scholar 

  18. Winograd C, Gerety M, Chung M, Goldstein M, Dominguez F Jr. Vallone R. Screening for frailty: criteria and predictors of outcomes. J Am Geriatr Soc 1991; 39: 778–84.

    CAS  Google Scholar 

  19. Posner J. Lin H. Effects of age on length of hospital stay in low-income population. Med Care 1975; 13: 855–75.

    CAS  Google Scholar 

  20. Walter L, Brand R, Counsell S, et al. Development and validation of prognostic index for 1-year mortalities in older adults after hospitalization. JAMA 2001; 285: 2987–94.

    Article  PubMed  CAS  Google Scholar 

  21. Saunders R Jr, Hickler R, Hall DS, Hitzhusen J, Ingraham M, Li L. A geriatric special-care unit: experience in university hospital. J Am Geriatr Soc 1983; 31: 685–93.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Mauro Zanocchi MD.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Zanocchi, M., Maero, B., Francisetti, F. et al. Multidimensional assessment and risk factors for prolonged hospitalization in the elderly. Aging Clin Exp Res 15, 305–309 (2003). https://doi.org/10.1007/BF03324514

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF03324514

Keywords

Navigation