Prognostic Factors for the Survival of Elderly Patients Who Were Hospitalized in the Medical Ward of Our Hospital in Japan.

Shuichi Abe

doi:10.3390/geriatrics2040032

Abstract

It has been a long time since there were many elderly people in Japan. The medical care and costs for the elderly are enormous, and research to lower the mortality rate of the elderly is needed. We retrospectively investigated the prognostic factors for the survival of elderly patients who were hospitalized in the medical ward of our hospital. In total, 277 patients who were hospitalized between 1 January 2014 and 31 May 2017, were included in the retrospective study. Univariate and multivariate analyses of items (vital signs, laboratory data, and so on) were performed, and significant differences between the survival group and death group were subjected to receiver operating characteristic curve analysis. Serum urea nitrogen levels and serum albumin levels provided a relatively high area under the curve (AUC). However, there was no item for which AUC exceeded 0.70, and setting the cutoff value in this study was difficult. For treating the elderly, it is important to carefully evaluate each patient’s prognostic factors, including the demented state, renal function, and nutritional state; personalized treatment of each patient is also important.

Highlights

The number of Japanese deaths in 2016 was 1,377,748, an increase of 17,304 from 1,294,444 in the previous year, and the death rate was 10.5, which was higher than the previous year’s 10.3
Significant differences were found in the degree of dementia, age, body weight, geriatric nutritional risk index (GNRI), controlling nutritional status (CONUT), body weight, body mass index, hospitalization day, maximum body temperature, oxygen saturation level in room air, oxygen flow rate after hospitalization, serum urea nitrogen value, serum creatinine value, serum sodium value, serum albumin value, serum cholinesterase value, and presence or absence of past stroke
It is known that factors such as low activity state, anorexia, inflammatory response, and the like have great influences on life prognosis in elderly people with chronic diseases

Summary

Introduction

The number of Japanese deaths in 2016 was 1,377,748, an increase of 17,304 from 1,294,444 in the previous year, and the death rate (per 1000 people) was 10.5, which was higher than the previous year’s 10.3. A prognostic index using specific items from the comprehensive geriatric assessment (CGA) [2] in a large population of older hospitalized adults [3], a statistical and clinical prognostic value related to the functional and nutritional changes due to an acute illness [4], or a multidimensional prognostic index calculated from information collected in a standardized CGA [2] accurately stratifies hospitalized elderly patients into groups at varying risk of mortality [5]. Because no study in Japan has directly reviewed the clinical outcome of all hospitalized patients in a general internal medicine ward, which does not differentiate by age or illness, we conducted research on patients in the medical care ward of our hospital, and evaluated the prognostic factors for the elderly. This study was conducted to investigate whether data at our hospital and research results are consistent with the results of research at other facilities reported so far, or whether new findings are obtained

Methods

Results

Conclusion