Dementia and in-hospital mortality: retrospective analysis of a nationwide administrative database of elderly subjects in Italy

Aims  To evaluate the relationship between comorbidity and in-hospital mortality in elderly patients affected by dementia. Methods Data were obtained from the Italian Ministry of Health and included all discharge records from Italian hospitals concerning subjects aged ≥ 65 years admitted to acute In...

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Published in:Aging clinical and experimental research 2022-05, Vol.34 (5), p.1037-1045
Main Authors: Zuliani, Giovanni, Gallerani, Massimo, Martellucci, Cecilia Acuti, Reverberi, Roberto, Brombo, Gloria, Cervellati, Carlo, Zuin, Marco, Pistolesi, Chiara, Pedrini, Dario, Flacco, Maria Elena, Manzoli, Lamberto
Format: Article
Language:English
Subjects:
Aged
Comorbidity
Dementia
Dementia - epidemiology
Geriatrics/Gerontology
Heart Failure
Hospital Mortality
Hospitalization
Hospitals
Humans
Kidney diseases
Male
Medicine
Medicine & Public Health
Mortality
Original Article
Pneumonia
Retrospective Studies
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Summary:Aims  To evaluate the relationship between comorbidity and in-hospital mortality in elderly patients affected by dementia. Methods Data were obtained from the Italian Ministry of Health and included all discharge records from Italian hospitals concerning subjects aged ≥ 65 years admitted to acute Internal Medicine or Geriatrics wards between January 2015 and December 2016 (3.695.278 admissions). The variables analyzed included age, sex, and in-hospital death. Twenty-five homogeneous clusters of diseases were identified in discharge codes according to the ICD-9-CM classification. Results Patients with dementia represented 7.5% of the sample (n. 278.149); they were older, more often males (51.9%), and had a higher in-hospital mortality (24.3%) compared to patients without dementia (9.7%). Dementia per se doubled the odds of death (OR 1.98; 95% CI 1.95–2.00), independent of age, sex, and comorbidities. Seven clusters of disease (pneumonia, heart failure, kidneys disease, cancer, infectious diseases, diseases of fluids/electrolytes and general symptoms) were associated with increased in-hospital mortality, independent of the presence/absence of dementia. Among patients with dementia, heart failure, pneumonia and kidney disease on their own substantially doubled/tripled mortality risk. The risk increased from 10.1% (none of selected conditions), up to 28.9% when only one of selected comorbidities was present, rising to 52.3% (OR: 9.34; p  
ISSN:1720-8319
1594-0667
1720-8319
DOI:10.1007/s40520-021-02021-8