Outcomes of hospitalized elderly patients with geriatric syndrome: report of a community hospital reform plan in Taiwan

• Published in: Archives of gerontology and geriatrics 2010-02, Vol.50, p.S30-S33
• Main Authors: Chang, Hao-Hsiang, Tsai, Shih-Li, Chen, Ching-Yu, Liu, Wen-Jing
• Format: Article
• Language: English
• Subjects: Activities of Daily Living; Aged; Cognition Disorders - diagnosis; Cognition Disorders - epidemiology; Cognition Disorders - therapy; Community Health Services - organization & administration; Community hospitals; Elderly people; Female; Frail elderly; Functional status; Geriatric syndrome; Health Care Reform; Health Services for the Aged - organization & administration; Health Status; Hospitalization - statistics & numerical data; Humans; Internal Medicine; Male; Minimental State Examination; Neuropsychological Tests; Outcome Assessment (Health Care); Outcome of geriatric assessment; Prospective Studies; Reforms; Severity of Illness Index; Syndrome; Taiwan - epidemiology
• ISSN: 0167-4943; 1872-6976
• DOI: 10.1016/S0167-4943(10)70009-1

Abstract The purpose of this study was to evaluate the outcomes of elderly inpatients with geriatric syndromes. A prospective study involving patients aged 65 years and older in 12 community hospitals was performed. Baseline data, which included demographic characteristics, mini mental status exam, geriatric depression scale (GDS), mini nutritional assessment (MNA), activities of daily living (ADL), and instrumental activities of daily living (IADL), were collected in geriatric assessments. The primary outcome was functional deterioration; additional outcomes included mortality, re-hospitalization, and emergency department visits, as identified by telephone interview and chart review. A total of 1,008 patients were recruited: 31.2% of the participants were ADL intact, 21.3% were IADL-intact, 11.5% had depression, 29.3% had nutritional problems, and 60.3% had impaired cognition at baseline. During follow-up, 172 patients (19.3%) died, 43.8% reported ADL deterioration, and 45.9% reported IADL deterioration. On multivariate analysis, older age, low mini mental state examination (MMSE) score, and low MNA score were predictors of functional deterioration. Under the interdisciplinary team care of the Community Hospital Reform Plan (CHRP), most of the elderly patients maintained or increased their functional capacity; the one-year mortality rate was higher than that of the general population but lower than that of other studies targeting the frail elderly.