Predicting a long hospital stay after admission to a geriatric assessment unit: Results from an observational retrospective cohort study

Maturitas. 2018 Sep:115:110-114. doi: 10.1016/j.maturitas.2018.06.014. Epub 2018 Jul 2.

Abstract

Objective: Morbidities and related disabilities often lead to older inpatients having a long hospital stay. The aim of this study was to examine whether the 6-item brief geriatric assessment (BGA), developed and validated in France to determine a priori levels of risk of a long hospital stay (i.e.; low, moderate, high), could be successfully used with patients admitted to a geriatric assessment unit (GAU) in Quebec.

Study design: Observational retrospective cohort design.

Setting: A GAU of a McGill University affiliated hospital (Montreal, Quebec, Canada).

Participants: 499 inpatients (84.7 ± 7.2 years; 73.3% female) recruited upon their admission.

Main outcome measures: The BGA comprises 6 items: age > 85 years, male gender, ≥ 5 drugs per day, use of home-help support, history of falls and temporal disorientation. It was administered at baseline and a priori levels of risk of a long hospital stay (i.e., low, moderate, high) were determined. Length of hospital stay (LHS, in days) was calculated using the hospital registry. The association between a priori levels of risk from the BGA and LSH was examined using regression models and Kaplan-Meier curves.

Results: The LHS increased with the 6-item BGA a priori level of risk (P = 0.010). High-risk (Hazard ratio (HR) = 1.68 with P < 0.001) and moderate-risk (HR = 1.24 with P = 0.039) of a long hospital stay successfully predicted a long stay. Kaplan-Meier distributions of time to discharge showed that inpatients classified as having high and moderate risk levels for a long hospital stay were discharged later than those with a low risk level (P < 0.001 and P = 0.013).

Conclusion: The 6-item BGA a priori levels of risk for a long hospital stay successfully predicted a long stay among patients admitted to a GAU in Quebec.

Keywords: Epidemiology; Frailty; Older inpatients; Screening.

Publication types

  • Observational Study

MeSH terms

  • Accidental Falls
  • Aged
  • Aged, 80 and over
  • Female
  • Geriatric Assessment*
  • Hospitals, University*
  • Humans
  • Inpatients
  • Length of Stay*
  • Male
  • Patient Discharge
  • Proportional Hazards Models
  • Quebec
  • Retrospective Studies