Respuesta de pacientes nonagenarios al tratamiento multidisciplinar y rehabilitador en una unidad geriátrica de media estancia

Abstract

Objective to determine the clinical, functional and mental characteristics of nonagenarians admitted to a medium-stay geriatric unit for hospital-based rehabilitation and to review outcomes at dischargeand 1 year later. Patients and method we performed a longitudinal observational study of nonagenarians consecutively hospitalised in a medium-stay geriatric unit over a 16-month period. On admission, the variables collected were diagnoses, functional and cognitive status, household composition, comorbidity, and serum albumin. The global and relative functional gain and rate of institutionalization at discharge were also evaluated. After 12 months, the patients were telephoned to establish mortality, functional status, and new admissions. Results the mean age of the 51 patients studied was 92.06 (SD 2.42) years and 75% were women. The mean functional gain at discharge was 23.27 (SD 14.06) in the Barthel Index (BI), with a relative functional gain of 45.4% from impairment at admission. At 1 year 31% of the patients were alive and living at home and showed a functional gain of ≥ 20 in the BI from admission. These outcomes increased to 59% in patients with better functional status before admission (previous BI ≥ 80) and absence of severe functional and cognitive impairment at admission (BI < 20 and Pfeiffer ≥ 5 at admission, respectively). Conclusions nonagenarians with recent onset of functional impairment also benefit from rehabilitation in a medium-stay geriatric unit; those with better functional and cognitive status can achieve results similar to those in younger patients.