Bacellar Aroldo, Assis Telma, Pedreira Bruno B, Costa Gersonita, Nascimento Osvaldo J M
Hospital Sao Rafael, Department of Neurology Av Sao Rafael 2152, Sao Marcos, Salvador, BA, CEP 41235-190, Brazil.
Open Neurol J. 2018 Jan 22;12:1-11. doi: 10.2174/1874205X01812010001. eCollection 2018.
Neurological disorders (NDs) are associated with high hospital mortality. We aimed to identify predictors of hospital mortality among elderly inpatients with NDs.
Patients aged ≥60 years admitted to the hospital between January 1, 2009 and December 31, 2010 with acute NDs, chronic NDs as underpinnings of acute clinical disorders, and neurological complications of other diseases were studied. We analyzed demographic data, NDs, and comorbidities as independent predictors of hospital mortality. Logistic regression was performed for multivariable analysis.
Overall, 1540 NDs and 2679 comorbidities were identified among 798 inpatients aged ≥ 60 years (mean 75.8±9.1). Of these, 54.5% were female. Diagnostic frequency of NDs ranged between 0.3% and 50.8%. Diagnostic frequency of comorbidities ranged from 5.6% to 84.5%. Comorbidities varied from 0 to 9 per patient (90% of patients had ≥2 comorbidities), mean 3.2±1.47(CI, 3.1-3.3). Patients with multimorbidities presented with a mean of 4.7±1.7 morbidities per patient. Each ND and comorbidity were associated with high hospital mortality, producing narrow ranges between the lowest and highest incidences of death (hospital mortality = 18%) (95% CI, 15%-21%). After multivariable analysis, advanced age (P<0.001) and low socioeconomic status (P=0.003) were recognized as predictors of mortality, totaling 9% of the variables associated with hospital mortality.
Neither a particular ND nor an individual comorbidity predicted hospital mortality. Age and low socioeconomic class accounted for 9% of predictors. We suggest evaluating whether functional, cognitive, or comorbidity scores will improve the risk model of hospital mortality in elderly patients admitted with ND.
神经系统疾病（NDs）与较高的医院死亡率相关。我们旨在确定老年神经系统疾病住院患者医院死亡率的预测因素。
对2009年1月1日至2010年12月31日期间因急性神经系统疾病、作为急性临床疾病基础的慢性神经系统疾病以及其他疾病的神经系统并发症而入院的≥60岁患者进行研究。我们分析了人口统计学数据、神经系统疾病和合并症，将其作为医院死亡率的独立预测因素。进行逻辑回归以进行多变量分析。
总体而言，在798名≥60岁的住院患者（平均年龄75.8±9.1岁）中，共识别出1540种神经系统疾病和2679种合并症。其中，54.5%为女性。神经系统疾病的诊断频率在0.3%至50.8%之间。合并症的诊断频率在5.6%至84.5%之间。每位患者的合并症数量从0到9不等（90%的患者有≥2种合并症），平均为3.2±1.47（CI，3.1 - 3.3）。患有多种合并症的患者平均每人有4.7±1.7种疾病。每种神经系统疾病和合并症都与较高的医院死亡率相关，最低和最高死亡率之间的范围较窄（医院死亡率 = 18%）（95% CI，15% - 21%）。经过多变量分析，高龄（P<0.001）和低社会经济地位（P = 0.003）被确定为死亡率的预测因素，占与医院死亡率相关变量的9%。
无论是特定的神经系统疾病还是个体合并症都不能预测医院死亡率。年龄和低社会经济阶层占预测因素的9%。我们建议评估功能、认知或合并症评分是否会改善患有神经系统疾病的老年住院患者医院死亡率的风险模型。
