Differential characteristics in polypathological inpatients in internal medicine departments and acute geriatric units: the PLUPAR study

Eur J Intern Med. 2013 Dec;24(8):767-71. doi: 10.1016/j.ejim.2013.07.010. Epub 2013 Aug 12.

Abstract

Aim: To determine whether there are any differences between polypathological patients attended in Internal Medicine departments and acute Geriatric units.

Methods: A cross-sectional multicenter study was performed. Polypathological patients admitted to an internal medicine or geriatrics department and attended by investigators consecutively between March 1 and June 30, 2011 were included. Data of age, sex, living in a nursing residence or at home, diagnostic category, use of chronic medication, Charlson, Barthel and Lawton-Brody indexes, Pfeiffer questionnaire, delirium during last admission, need of a caregiver, and having a caregiver were gathered. The need of a caregiver was defined when the Barthel index was<60 or Pfeiffer questionnaire ≥ 3 errors.

Results: 471 polypathological patients, 337 from internal medicine and 144 from geriatrics units were included. Geriatrics inpatients were older and more frequently female. Cardiac (62.1% vs 49.6%; p=.01), digestive (8.3% vs 3.0%; p=.04) and oncohematological diseases (30.2% vs 18.8%; p=.01) were more frequent in patients of internal medicine units and neurological (66.2% vs 40.2%; p<.001) and locomotive ones (39.1% vs 20.4%; p<.001) in geriatrics inpatients. Charlson index was higher for internal medicine inpatients [4.0(2.1) vs 3.5(2.1); p=.04). Patients attended in geriatrics scored higher in Pfeiffer questionnaire [5.5(3.7) vs 3.8(3.3); p<.001], and lower in Barthel [38.8(32.5) vs 61.2(34.3); p=.001] and Lawton-Brody indexes [0.9(1.6) vs 3.0(2.9); p<.001], and more frequently needed a caregiver (87.8% vs 53.6%; p<.001) and had it.

Conclusions: There are differences in disease profile and functional and cognitive situation between polypathological patients of internal medicine and geriatrics departments.

Keywords: Cognitive impairment; Dependence; Geriatrics; Internal medicine; Multimorbidity; Polypathological patient.

Publication types

  • Multicenter Study

MeSH terms

  • Age Distribution
  • Aged
  • Aged, 80 and over
  • Comorbidity*
  • Cross-Sectional Studies
  • Female
  • Geriatrics
  • Hospital Departments / statistics & numerical data
  • Hospital Units / statistics & numerical data
  • Hospitalization / statistics & numerical data*
  • Humans
  • Internal Medicine
  • Male
  • Sex Distribution
  • Spain