Functional impairment and serum albumin predict in-hospital mortality in nonagenarians with acute infection: a retrospective cohort study

Wei Huang,Cuiying Wang,Yunli Xing,Ying Sun

doi:10.1186/s12877-019-1301-1

Wei Huang, Cuiying Wang + Show 2 more

Open Access

https://doi.org/10.1186/s12877-019-1301-1

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Abstract

BackgroundAcute infection leads to substantial mortality in the nonagenarian population. However, the predictive efficacies of functional status and biochemical indexes for in-hospital mortality in these patients remain to be determined.MethodsA single-center, retrospective cohort study was performed. Consecutive nonagenarian patients who were admitted to our department from January 1, 2014 to December 31, 2016 for acute infectious diseases were included. Baseline data for medical history, functional status, and biochemical indexes were obtained on admission. The outcomes of these patients during hospitalization were recorded. Predictors of in-hospital mortality were identified via logistic regression analyses.ResultsA total of 162 patients were included, and 46 patients died (17.2%) during hospitalization. Univariate analysis showed that the prevalence rates of atrial fibrillation (32.1%) and malignant disease (26.5%) were higher in nonagenarian patients who died during hospitalization than in those who discharged. Multivariate logistic regression analyses identified malignant disease (odds ratio [OR] 2.73, 95% confidence interval [CI]: 1.10–6.78), ADL category (OR 0.82, 95% CI: 0.75–0.89) and serum albumin (OR 0.86, 95%CI 0.78–0.95) as independent predictors of in-hospital mortality in nonagenarian patients hospitalized for acute infection.ConclusionsFunctional impairment as well as serum albumin may be independent predictors of in-hospital mortality in nonagenarian patients hospitalized for acute infectious diseases. Stratification of patients according to Barthel Index score and serum albumin is very necessary.

Highlights

Acute infection leads to substantial mortality in the nonagenarian population
Compared with those who were discharged, patients who died during hospitalization were older, more likely to have atrial fibrillation, and more likely to have a history of malignant disease (Table 1)
Functional impairment as well as serum albumin were independent predictors of in-hospital mortality in our cohort of nonagenarian patients hospitalized for acute infectious diseases

Summary

Introduction

Acute infection leads to substantial mortality in the nonagenarian population. In developing countries like China, the percentage of people aged 90 and above had reached 0.19% in 2015 with the increase of the average life expectancy from 72.95 years in 2005 to 76.34 years in 2015 [2]. These populations are generally excluded from most clinical trials. Huang et al BMC Geriatrics (2019) 19:269 characteristics of the nonagenarian patients admitted for acute infection, and more importantly, the predictors of inhospital mortality in these patients, remain to be determined.

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