Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy.
*Joint co-first authors.
Clin Med (Lond). 2023 Jan;23(1):16-23. doi: 10.7861/clinmed.2022-0176.
We sought to quantify in-hospital and early post-discharge mortality rates in hospitalised patients.
Consecutive adult patients admitted to an internal medicine ward were prospectively enrolled. The rates of in-hospital and 4-month post-discharge mortality and their possible associated sociodemographic and clinical factors (eg Cumulative Illness Rating Scale [CIRS], body mass index [BMI], polypharmacy, Barthel Index) were assessed.
1,451 patients (median age 80 years, IQR 69-86; 53% female) were included. Of these, 93 (6.4%) died in hospital, while 4-month post-discharge mortality was 15.9% (191/1,200). Age and high dependency were associated (p<0.01) with a higher risk of in-hospital (OR 1.04 and 2.15) and 4-month (HR 1.04 and 1.65) mortality, while malnutrition and length of stay were associated (p<0.01) with a higher risk of 4-month mortality (HR 2.13 and 1.59).
Several negative prognostic factors for early mortality were found. Interventions addressing dependency and malnutrition could potentially decrease early post-discharge mortality.
我们旨在量化住院患者的院内和出院后早期死亡率。
连续纳入入住内科病房的成年患者。评估了院内和出院后 4 个月的死亡率及其可能相关的社会人口学和临床因素(例如累积疾病评分量表[CIRS]、体重指数[BMI]、多种药物治疗、巴氏指数)。
共纳入 1451 例患者(中位年龄 80 岁,IQR 69-86;53%为女性)。其中,93 例(6.4%)在院内死亡,出院后 4 个月的死亡率为 15.9%(191/1200)。年龄和高依赖度与较高的院内(OR 1.04 和 2.15)和出院后 4 个月(HR 1.04 和 1.65)死亡率相关,而营养不良和住院时间与较高的出院后 4 个月死亡率相关(HR 2.13 和 1.59)。
发现了一些与早期死亡率相关的负面预后因素。针对依赖度和营养不良的干预措施可能会降低出院后早期死亡率。