TY - JOUR
T1 - Activities of daily living at hospital admission and estimated survival time of older patients
AU - Ryg, Jesper
AU - Engberg, Henriette
AU - Anru, Pavithra Laxsen
AU - Pedersen, Solvejg Gram Henneberg
AU - Jorgensen, Martin Gronbech
AU - Vinding, Kirsten Laila
AU - Masud, Tahir
AU - Andersen-Ranberg, Karen
N1 - © The Author(s) 2020. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.
PY - 2021/7
Y1 - 2021/7
N2 - BACKGROUND: Predicting expected survival time in acutely hospitalised older patients is a clinical challenge.OBJECTIVE: To examine if activities of daily living (ADL) assessed by Barthel-Index-100 (Barthel-Index) at hospital admission adds useful information to clinicians on expected survival time in older patients.METHODS: A nationwide population-based cohort study was used. All patients aged ≥65 years in the National Danish Geriatric Database from 2005 to 2014 were followed up until death, emigration or study termination (31 December 2015). Individual data were linked to national health registers. Barthel-Index was categorised into five-point subcategories with a separate category of Barthel-Index = 0. Kaplan-Meier analysis was used to assess crude survival proportions (95% CI) and Cox regression to examine association of Barthel-Index and mortality adjusting for age, Charlson comorbidity index, medication use, BMI, marital status, prior hospitalisations and admission year.RESULTS: In total, 74,589 patients (63% women) aged (mean (SD)) 82.5(7.5) years with Barthel-Index (median (IQR)) 54(29-77) were included. In patients with Barthel-Index = 100-96 crude survival was 0.96(0.95-0.97) after 90-days, 0.88(0.87-0.89) after 1-year, and 0.79(0.78-0.80) after 2-years. Corresponding survival in patients with Barthel-Index = 0 was 0.49(0.47-0.51), 0.35(0.34-0.37) and 0.26(0.24-0.27). Decreasing Barthel-Index was associated with increasing mortality in the multivariable analysis. In women with Barthel-Index = 0, the mortality risk (HR (95% CI)) was 14.74(11.33-19.18) after 90-days, 8.40(7.13-9.90) after 1-year and 6.22(5.47-7.07) after 2-years using Barthel-Index = 100-96 as reference. In men, the corresponding risks were 11.36(8.81-14.66), 6.22(5.29-7.31) and 5.22(4.56-5.98).CONCLUSIONS: ADL measured by Barthel-Index provides useful, easily accessible and independent information to clinicians on expected survival time in patients admitted to a geriatric department.
AB - BACKGROUND: Predicting expected survival time in acutely hospitalised older patients is a clinical challenge.OBJECTIVE: To examine if activities of daily living (ADL) assessed by Barthel-Index-100 (Barthel-Index) at hospital admission adds useful information to clinicians on expected survival time in older patients.METHODS: A nationwide population-based cohort study was used. All patients aged ≥65 years in the National Danish Geriatric Database from 2005 to 2014 were followed up until death, emigration or study termination (31 December 2015). Individual data were linked to national health registers. Barthel-Index was categorised into five-point subcategories with a separate category of Barthel-Index = 0. Kaplan-Meier analysis was used to assess crude survival proportions (95% CI) and Cox regression to examine association of Barthel-Index and mortality adjusting for age, Charlson comorbidity index, medication use, BMI, marital status, prior hospitalisations and admission year.RESULTS: In total, 74,589 patients (63% women) aged (mean (SD)) 82.5(7.5) years with Barthel-Index (median (IQR)) 54(29-77) were included. In patients with Barthel-Index = 100-96 crude survival was 0.96(0.95-0.97) after 90-days, 0.88(0.87-0.89) after 1-year, and 0.79(0.78-0.80) after 2-years. Corresponding survival in patients with Barthel-Index = 0 was 0.49(0.47-0.51), 0.35(0.34-0.37) and 0.26(0.24-0.27). Decreasing Barthel-Index was associated with increasing mortality in the multivariable analysis. In women with Barthel-Index = 0, the mortality risk (HR (95% CI)) was 14.74(11.33-19.18) after 90-days, 8.40(7.13-9.90) after 1-year and 6.22(5.47-7.07) after 2-years using Barthel-Index = 100-96 as reference. In men, the corresponding risks were 11.36(8.81-14.66), 6.22(5.29-7.31) and 5.22(4.56-5.98).CONCLUSIONS: ADL measured by Barthel-Index provides useful, easily accessible and independent information to clinicians on expected survival time in patients admitted to a geriatric department.
KW - Activities of daily living
KW - Barthel Index
KW - Cohort study
KW - Geriatric patients
KW - Mortality
UR - http://www.scopus.com/inward/record.url?scp=85111789726&partnerID=8YFLogxK
U2 - 10.1093/ageing/afaa251
DO - 10.1093/ageing/afaa251
M3 - Journal article
C2 - 33247584
SN - 0002-0729
VL - 50
SP - 1200
EP - 1207
JO - Age and Ageing
JF - Age and Ageing
IS - 4
M1 - afaa251
ER -