Effect of a geriatric unit in the outcomes of hospitalized older Mexican adults with cancer: A case-control study

Abstract

IntroductionGeriatric interventions may improve the care of hospitalized older adults with cancer, but information regarding their effect on geriatric-specific outcomes is lacking. We studied the effect of a specialized geriatrician-led inpatient geriatric management unit compared with a conventional internal medicine ward on the outcomes of hospitalized older adults with cancer in Mexico. Materials and MethodsCase-control study including persons aged ≥65 years with solid malignancies who had a cancer-related hospitalization at a university-affiliated hospital in Mexico City. Patients hospitalized in a geriatric unit (cases) were paired 1:2 with those in internal medicine wards (controls). Matching criteria included: age (+/− five years), tumor type (according to International Classification of Diseases [ICD]-10 code), and admission date (+/− three months). The association between being hospitalized in the geriatric unit on various outcomes was determined using conditional logistic regression models. ResultsOne hundred cases and 200 controls were included. Mean age was 75.3 years (standard deviation 6.4 years) and 53% had gastrointestinal tumors. No difference in median length-of-stay was found between cases and controls (9.0 days, vs. 9.5 days, p = 0.34). Hospitalization in the geriatric unit was associated with a reduced risk of delirium (odds ratio [OR] 0.18, 95% confidence interval [CI] 0.04–0.80). Being hospitalized in the geriatric unit was not associated with an effect on hospital-acquired complications (OR 0.83, 95% CI 0.47–1.45) or in-hospital mortality (OR 1.82, 95% CI 0.32–10.18). DiscussionAmong older Mexican adults hospitalized for a cancer-related diagnosis, receiving care in a geriatric management unit was associated to a decreased risk of delirium, without influencing other outcomes.