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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 |
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| creator | Zuliani, Giovanni Gallerani, Massimo Martellucci, Cecilia Acuti Reverberi, Roberto Brombo, Gloria Cervellati, Carlo Zuin, Marco Pistolesi, Chiara Pedrini, Dario Flacco, Maria Elena Manzoli, Lamberto |
| description | 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
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| doi_str_mv | 10.1007/s40520-021-02021-8 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2599181644</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2599181644</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-d5760e34b35fd9a1427739a431a7c4592915710e8513c54e4fb51fad8c84b6523</originalsourceid><addsrcrecordid>eNp9kU9vFiEQxomxsbXtF_BgSLz0shUWWMCbadU2adJLeybsMlt5s39egdXsya_uvH1bNR48wMDMb54JPIS84eycM6bfZ8lUzSpWc1y73bwgR1xjyghuX_51PiSvc94wJjleXpFDIbVtZMOPyM9LGGEq0VM_BRqn6uuct7H4gY5zwhDL-oEmKAnT0JX4HRD0w5pjpnNPPZ18ifP0IwYshDFOMZfkH7ngi299hh0HQ4A0rDQv7QZlMk6i1yi_npCD3g8ZTp_iMbn__Onu4qq6uf1yffHxpuqEVqUKSjcMhGyF6oP1XNZaC-ul4F53UtnacqU5A6O46JQE2beK9z6Yzsi2UbU4Jmd73W2avy2Qixtj7mAY_ATzkl2trOWGN1Ii-u4fdDMvCR-NVNNYbaUxHKl6T3X4NTlB77Ypjj6tjjO3s8ft7XFojHu0xxlsevskvbQjhN8tz34gIPZAxtL0AOnP7P_I_gJfyJub</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2669794881</pqid></control><display><type>article</type><title>Dementia and in-hospital mortality: retrospective analysis of a nationwide administrative database of elderly subjects in Italy</title><source>Springer Nature</source><creator>Zuliani, Giovanni ; Gallerani, Massimo ; Martellucci, Cecilia Acuti ; Reverberi, Roberto ; Brombo, Gloria ; Cervellati, Carlo ; Zuin, Marco ; Pistolesi, Chiara ; Pedrini, Dario ; Flacco, Maria Elena ; Manzoli, Lamberto</creator><creatorcontrib>Zuliani, Giovanni ; Gallerani, Massimo ; Martellucci, Cecilia Acuti ; Reverberi, Roberto ; Brombo, Gloria ; Cervellati, Carlo ; Zuin, Marco ; Pistolesi, Chiara ; Pedrini, Dario ; Flacco, Maria Elena ; Manzoli, Lamberto</creatorcontrib><description>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
< 0.001) when two or more comorbidities were simultaneously diagnosed, besides general symptoms.
Conclusions
Our study confirmed an important increase of in-hospital mortality in older subjects with dementia. Despite a different comorbidity, the conditions associated with in-hospital mortality were substantially the same in patients with or without dementia. Heart failure, pneumonia, and kidney disease identified a high risk of in-hospital mortality among subjects with dementia.</description><identifier>ISSN: 1720-8319</identifier><identifier>ISSN: 1594-0667</identifier><identifier>EISSN: 1720-8319</identifier><identifier>DOI: 10.1007/s40520-021-02021-8</identifier><identifier>PMID: 34796461</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Comorbidity ; Dementia ; Geriatrics/Gerontology ; Heart failure ; Hospitals ; Kidney diseases ; Medicine ; Medicine & Public Health ; Mortality ; Original Article ; Pneumonia</subject><ispartof>Aging clinical and experimental research, 2022-05, Vol.34 (5), p.1037-1045</ispartof><rights>The Author(s), under exclusive licence to Springer Nature Switzerland AG 2021</rights><rights>2021. The Author(s), under exclusive licence to Springer Nature Switzerland AG.</rights><rights>The Author(s), under exclusive licence to Springer Nature Switzerland AG 2021.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-d5760e34b35fd9a1427739a431a7c4592915710e8513c54e4fb51fad8c84b6523</citedby><cites>FETCH-LOGICAL-c375t-d5760e34b35fd9a1427739a431a7c4592915710e8513c54e4fb51fad8c84b6523</cites><orcidid>0000-0003-4777-6300</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34796461$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Zuliani, Giovanni</creatorcontrib><creatorcontrib>Gallerani, Massimo</creatorcontrib><creatorcontrib>Martellucci, Cecilia Acuti</creatorcontrib><creatorcontrib>Reverberi, Roberto</creatorcontrib><creatorcontrib>Brombo, Gloria</creatorcontrib><creatorcontrib>Cervellati, Carlo</creatorcontrib><creatorcontrib>Zuin, Marco</creatorcontrib><creatorcontrib>Pistolesi, Chiara</creatorcontrib><creatorcontrib>Pedrini, Dario</creatorcontrib><creatorcontrib>Flacco, Maria Elena</creatorcontrib><creatorcontrib>Manzoli, Lamberto</creatorcontrib><title>Dementia and in-hospital mortality: retrospective analysis of a nationwide administrative database of elderly subjects in Italy</title><title>Aging clinical and experimental research</title><addtitle>Aging Clin Exp Res</addtitle><addtitle>Aging Clin Exp Res</addtitle><description>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
< 0.001) when two or more comorbidities were simultaneously diagnosed, besides general symptoms.
Conclusions
Our study confirmed an important increase of in-hospital mortality in older subjects with dementia. Despite a different comorbidity, the conditions associated with in-hospital mortality were substantially the same in patients with or without dementia. Heart failure, pneumonia, and kidney disease identified a high risk of in-hospital mortality among subjects with dementia.</description><subject>Comorbidity</subject><subject>Dementia</subject><subject>Geriatrics/Gerontology</subject><subject>Heart failure</subject><subject>Hospitals</subject><subject>Kidney diseases</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Mortality</subject><subject>Original Article</subject><subject>Pneumonia</subject><issn>1720-8319</issn><issn>1594-0667</issn><issn>1720-8319</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><recordid>eNp9kU9vFiEQxomxsbXtF_BgSLz0shUWWMCbadU2adJLeybsMlt5s39egdXsya_uvH1bNR48wMDMb54JPIS84eycM6bfZ8lUzSpWc1y73bwgR1xjyghuX_51PiSvc94wJjleXpFDIbVtZMOPyM9LGGEq0VM_BRqn6uuct7H4gY5zwhDL-oEmKAnT0JX4HRD0w5pjpnNPPZ18ifP0IwYshDFOMZfkH7ngi299hh0HQ4A0rDQv7QZlMk6i1yi_npCD3g8ZTp_iMbn__Onu4qq6uf1yffHxpuqEVqUKSjcMhGyF6oP1XNZaC-ul4F53UtnacqU5A6O46JQE2beK9z6Yzsi2UbU4Jmd73W2avy2Qixtj7mAY_ATzkl2trOWGN1Ii-u4fdDMvCR-NVNNYbaUxHKl6T3X4NTlB77Ypjj6tjjO3s8ft7XFojHu0xxlsevskvbQjhN8tz34gIPZAxtL0AOnP7P_I_gJfyJub</recordid><startdate>20220501</startdate><enddate>20220501</enddate><creator>Zuliani, Giovanni</creator><creator>Gallerani, Massimo</creator><creator>Martellucci, Cecilia Acuti</creator><creator>Reverberi, Roberto</creator><creator>Brombo, Gloria</creator><creator>Cervellati, Carlo</creator><creator>Zuin, Marco</creator><creator>Pistolesi, Chiara</creator><creator>Pedrini, Dario</creator><creator>Flacco, Maria Elena</creator><creator>Manzoli, Lamberto</creator><general>Springer International Publishing</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-4777-6300</orcidid></search><sort><creationdate>20220501</creationdate><title>Dementia and in-hospital mortality: retrospective analysis of a nationwide administrative database of elderly subjects in Italy</title><author>Zuliani, Giovanni ; Gallerani, Massimo ; Martellucci, Cecilia Acuti ; Reverberi, Roberto ; Brombo, Gloria ; Cervellati, Carlo ; Zuin, Marco ; Pistolesi, Chiara ; Pedrini, Dario ; Flacco, Maria Elena ; Manzoli, Lamberto</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-d5760e34b35fd9a1427739a431a7c4592915710e8513c54e4fb51fad8c84b6523</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Comorbidity</topic><topic>Dementia</topic><topic>Geriatrics/Gerontology</topic><topic>Heart failure</topic><topic>Hospitals</topic><topic>Kidney diseases</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Mortality</topic><topic>Original Article</topic><topic>Pneumonia</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zuliani, Giovanni</creatorcontrib><creatorcontrib>Gallerani, Massimo</creatorcontrib><creatorcontrib>Martellucci, Cecilia Acuti</creatorcontrib><creatorcontrib>Reverberi, Roberto</creatorcontrib><creatorcontrib>Brombo, Gloria</creatorcontrib><creatorcontrib>Cervellati, Carlo</creatorcontrib><creatorcontrib>Zuin, Marco</creatorcontrib><creatorcontrib>Pistolesi, Chiara</creatorcontrib><creatorcontrib>Pedrini, Dario</creatorcontrib><creatorcontrib>Flacco, Maria Elena</creatorcontrib><creatorcontrib>Manzoli, Lamberto</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Aging clinical and experimental research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zuliani, Giovanni</au><au>Gallerani, Massimo</au><au>Martellucci, Cecilia Acuti</au><au>Reverberi, Roberto</au><au>Brombo, Gloria</au><au>Cervellati, Carlo</au><au>Zuin, Marco</au><au>Pistolesi, Chiara</au><au>Pedrini, Dario</au><au>Flacco, Maria Elena</au><au>Manzoli, Lamberto</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Dementia and in-hospital mortality: retrospective analysis of a nationwide administrative database of elderly subjects in Italy</atitle><jtitle>Aging clinical and experimental research</jtitle><stitle>Aging Clin Exp Res</stitle><addtitle>Aging Clin Exp Res</addtitle><date>2022-05-01</date><risdate>2022</risdate><volume>34</volume><issue>5</issue><spage>1037</spage><epage>1045</epage><pages>1037-1045</pages><issn>1720-8319</issn><issn>1594-0667</issn><eissn>1720-8319</eissn><abstract>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
< 0.001) when two or more comorbidities were simultaneously diagnosed, besides general symptoms.
Conclusions
Our study confirmed an important increase of in-hospital mortality in older subjects with dementia. Despite a different comorbidity, the conditions associated with in-hospital mortality were substantially the same in patients with or without dementia. Heart failure, pneumonia, and kidney disease identified a high risk of in-hospital mortality among subjects with dementia.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>34796461</pmid><doi>10.1007/s40520-021-02021-8</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0003-4777-6300</orcidid></addata></record> |
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| source | Springer Nature |
| subjects | Comorbidity Dementia Geriatrics/Gerontology Heart failure Hospitals Kidney diseases Medicine Medicine & Public Health Mortality Original Article Pneumonia |
| title | Dementia and in-hospital mortality: retrospective analysis of a nationwide administrative database of elderly subjects in Italy |
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