Abstract
ObjectiveOrthostatic hypotension (OH) is a common problem in older people. Although it is indicated that OH can be a marker of frailty there are no studies that evaluate this relationship in hospitalized patients. The aim of the study was to assess the prevalence of OH in geriatric ward patients and its association with health and functional ability characteristics and patients’ frailty status.Design and settingA retrospective cross-sectional cohort study was conducted among patients aged 60 or over hospitalized in the geriatric ward.ParticipantsPatients’ medical records were analyzed and those with Active Standing Test (AST) results were included in the study.MeasurementsOrthostatic hypotension was defined by a drop in blood pressure of at least 20mmHg for systolic blood pressure and at least 10mmHg for diastolic blood pressure within 3minutes of standing up in AST. The database included sociodemographic characteristics, nutritional, functional and cognitive state, comorbidity and medical treatment. Frailty syndrome was diagnosed with Clinical Frailty Scale. Correlations with OH were counted and multivariable logistic regression models were built.Results416 patients were hospitalized in the study period and 353 (84.9%) were included, 78 (22.1%) men and 298 (84.4%) 75+ year-old. AST was not available in patients significantly more dependent in ADL and more frail. OH was diagnosed in 57 (16.2%) patients, significantly more frequently in men (systolic- 45,5%, systolic-diastolic-40,0%). The significant independent predictors of OH were lower diastolic blood pressure at admittance, nutritional risk in MNA-SF, Parkinson disease, α1-blockers, neuroleptics and memantine, and not the frailty syndrome diagnosed with Clinical Frailty Scale.ConclusionsOH affects a significant percentage of patients in the geriatric ward, although this problem may be underestimated due to limitations in the performance of AST in very frail and functionally dependent patients.
Highlights
There were 416 patients hospitalized in the study period and 353 (84.9%) had Active Standing Test (AST) result documented in the medical record and were included in the study group
An independent positive effect associated with the prevalence of Orthostatic hypotension (OH) in AST was observed among male patients, with lower values of diastolic blood pressure, at risk of malnutrition according to MNA-SF, and taking memantine
The results of our study revealed that OH affects a significant percentage of patients in the geriatric ward
Summary
1. Department of Geriatrics, Medical University of Bialystok, Bialystok, Poland; 2. Doctoral Studies, Department of Geriatrics, Medical University of Bialystok, Poland.
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