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Characteristics and determinants of survival in oldest old nursing home residents admitted to hospital with an acute illness compared to their younger counterparts

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Abstract

Background and objectives

The clinical problems and needs of our oldest old (≥85 years) are often substantially different from those of younger patients, and are arguably different from younger elderly patients (age 65–84). With the increasing number of frail oldest olds residing in Nursing Homes (NH), we aim to identify differences in prognostic indicators and outcomes in this age group compared to younger NH residents.

Methods

We retrospectively identified all consecutive admissions from NHs to an Acute Medical Assessment Unit between January 2005 and December 2007. Admission prognostic indicators and outcomes at follow-up were compared between younger (<85) and older (≥85) age groups. Using multiple regression methods controlling for potential confounders, we compared in-hospital mortality and long-term survival after discharge between the groups.

Results

Three hundred and sixteen patients (mean age 84.3, SD 8.34 years) were included (68 % females). Admission characteristics were mostly similar between age groups. In-hospital mortality rates were not significantly different between groups, even after adjusting for possible confounders. Oldest old patients had a significantly greater hazard of dying after discharge (HR 1.37; 1.03–1.83) compared to the younger group after removing explanatory variables with more than 5 % missing data.

Conclusion

Whilst the admission characteristics are similar between younger and older patients from NHs, there is evidence to suggest worse long-term survival prospects for oldest old patients.

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Conflicts of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Author information

Authors and Affiliations

  1. Academic Department of Medicine for the Elderly, Norfolk and Norwich University Hospital, Norwich, Norfolk, NR4 7UY, UK

    Katie Honney & John F. Potter

  2. Department of Acute Medicine, Ipswich Hospital, Ipswich, UK

    Nicola J. B. Trepte, Jasmine Patel & Robert Mallinson

  3. Department of Public Health and Primary Care, Centre for Applied Medical Statistics, University of Cambridge, Cambridge, UK

    Richard A. Parker

  4. Acute Medical Unit, Doncaster and Bassetlaw NHS Foundation Trust, Doncaster, South Yorkshire, UK

    Sayed J. Sultanzadeh

  5. Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich, UK

    John F. Potter

  6. AGEING (Aberdeen Gerontological & Epidemiological INterdisciplinary Research Group), Epidemiology Group, Institute of Applied Health Sciences, School of Medicine & Dentistry, University of Aberdeen, Aberdeen, AB25 2ZD, Scotland, UK

    Phyo Kyaw Myint

  7. Academic Centre for Applied Clinical & Translational Research into Ageing (ACTRA), Department of Medicine for the Elderly, Aberdeen Royal Infirmary, NHS Grampian, Aberdeen, AB25 2ZN, Scotland, UK

    Phyo Kyaw Myint

Authors
  1. Katie Honney
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  2. Nicola J. B. Trepte
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  3. Richard A. Parker
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  4. Jasmine Patel
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  6. Sayed J. Sultanzadeh
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  7. John F. Potter
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  8. Phyo Kyaw Myint
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Corresponding author

Correspondence to Katie Honney.

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Honney, K., Trepte, N.J.B., Parker, R.A. et al. Characteristics and determinants of survival in oldest old nursing home residents admitted to hospital with an acute illness compared to their younger counterparts. Aging Clin Exp Res 26, 153–160 (2014). https://doi.org/10.1007/s40520-013-0145-3

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  • DOI: https://doi.org/10.1007/s40520-013-0145-3

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