Mortality predictors in an acute care geriatric unit in Singapore

Abstract

Aim: Admission to an acute care geriatric unit may lead to adverse outcomes. It is therefore important to identify high-risk patients early so that appropriate management can be instituted to prevent or delay onset of adverse events. The aim of this study is to evaluate one-year mortality and its associated risk factors among hospitalized patients. Methods: This is a retrospective cohort study on consecutive patients admitted to an acute geriatric ward in a Singapore hospital from March to April 2013.Demographic and clinical information was collected from patient medical records. Linkage with death records from a national registry was performed. Results: Of the 196 patients assessed, 4.6%, 20.9% and 35.7% died during admission, within six months post-admission and within one year post-admission respectively. Pneumonia and cardiovascular diseases accounted for most of the death cases. In the multivariable logistic regression adjusted by age and gender, abbreviated mental test (AMT) score, admission for falls and depression were found to be significantly associated with death within one year post-admission. In the analysis stratified by gender, AMT score and depression were found to be significantly associated with death in males whereas AMT score and admission for falls were significantly associated with death in females. Conclusions: This study offers significant insight into mortality trends and risk factors for clinicians, hence guiding them in individualizing their management plan for acutely ill geriatric patients. Predicting long-term prognosis will enhance rehabilitation goal-setting and advance care-planning.