Gender Differences and Health Status in Old and Very Old Patients

Abstract

To examine gender differences according to health status, social support, and DRG reimbursement in a population of elderly patients admitted to a hospital geriatric ward in Italy and also to examine the patterns of these differences across old age strata. Observational study A total of 2171 patients, 70 years and older (females = 1088), consecutively admitted for acute care to a geriatric ward in a general hospital during a 30-month period were included. Patients were stratified into 3 age groups: 70 to 79 (n = 1038, females = 521), 80 to 89 (n = 948, females = 476), and 90+ (n = 185, females = 91). Demographics, main reason for hospitalization, Charlson Index, APACHE II score, APACHE II-APS subscore, serum albumin, number of currently administered drugs, cognitive status, depression, functional status, length of stay, Diagnoses Related Group (DRG) weight, in-hospital, and 3-month mortality were recorded. Differences were evaluated according to gender across old age strata. In the group of 70- to 79-year-old patients, significant differences were found regarding number of comorbidities, biological and clinical markers of clinical severity (ie, serum albumin, APS, delirium), and functional status on admission (ie, the greater impairment was found in male patients, with a higher in-hospital and 3-month mortality). Moreover, females had less social support and more often live alone. DRG weight parallels clinical complexity, whereas length of stay is comparable. Gender differences were less evident in the 80-89 year-old patients and almost absent in those 90+. Data indicate that on hospital admission gender differences are significant in young old patients, but not in old and very old, suggesting a poor survivorship of males with increasing age.