Jurnal Penyakit Dalam Indonesia (Sep 2021)
In-Hospital Mortality Risk Factors among Hospitalized Geriatric Patients: A Cohort Study on Tertiary Referral Hospital in Indonesia
Abstract
Introduction. Decreasing fertility rates and increasing life expectancy cause an increase in the population of the elderly, with the number of elderly in the world is estimated to increase from 9.3% in 2020 to 16.0% in 2050. 24.35% of the elderly in Indonesia experience illness, and 8.71% have been hospitalized in one year. This study aimed to determine the risk factors for the death of elderly who were hospitalized. Methods. A retrospective cohort study using secondary data from the medical records of geriatric patients hospitalized during 2017 in a tertiary referral hospital in Indonesia. Using a total sample of 4374 patients over 60 years of age, then selected according to inclusion and exclusion criteria so that a sample of 3095 patients was obtained. This study used bivariate analysis with chi-square test and multivariate analysis with logistic regression to determine the relationship between mortality of hospitalized geriatric patients with gender, age, Length of Stay (LoS), malignancy, Charlson Comorbidity Index (CCI), and the number of rehospitalization in the last year. Results. The following risk factors associated with the mortality of hospitalized geriatric patients: age (OR=1.23, 95% CI 1.1-1.38, p<0.001), LoS (OR=1.43, 95% CI 1.33-1.53, p<0.001), malignancy (OR=1.46, 95% CI 1.1-1.93, p=0.001), CCI (OR=1.18, 95% CI 1.04-1,34, p= 0.009), number of rehospitalizations in the last year (OR= 1.52, 95% CI 1.19-1.93, p=0.008). Conclusions. The increase in age, short LoS, presence of malignancy, high CCI score, and the number of rehospitalizations in the last year affected the mortality of hospitalized geriatric patients. Therefore, it is important to identify the profile and risk factors of elderly patients so that improving treatment outcomes and reducing mortality in hospitalized geriatric patients.
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