Analysis of related factors for clinical characteristics and the outcome in centenarian hospitalized patients
Wang Yu, Song Weiwei, Chen Xiaoli, Wang Zhiyong, Dai Jian, Ouyang Xiaojun, Liu Lili, Liu Yu, Zhang Peng, Guo Zhaoling, Wei Yunyan, Chen Jihai, Yuan Weiwei, Zhao Weihong, Wu Jianqing, Xu Wei
Abstract
ObjectiveTo investigate the health status of centenarian hospitalized patients and analyze the risk factors for in-hospital death in Nanjing district.
MethodsAll centenarians hospitalized patients who were discharged from wards of 10 upper first-class general hospitals in Nanjing district during the past five years were retrieved from their hospital information systems.Then, a retrospective study was performed on centenarians' data of general information, laboratory test results, Charlson comorbidity index(CCI), neutrophil to lymphocyte ratio(NLR)and shock index(SI), etc.were calculated and collected.Relevant risk factors for in-hospital death were analyzed by multivariate logistic regression analysis.
ResultsA total of 156 patients aged 100 years and over, with an average age of (101.0±2.1)years, were enrolled during the past 5 years.The top 3 admitting diagnosis for the patients were pulmonary infection(30.1%, 47/156 cases), coronary heart disease(10.9%, 17/156 cases)and cerebrovascular disease(7.1%, 11/156 cases). Fifty patients died during hospitalization, with a mortality of 32.1%(50/156). Pneumonia was the most common admitting diagnosis(40.0%, 20/50 case). Among causes of death, the combined admitting diagnosis with dementia, chronic renal insufficiency, one or more basic disease were significantly associated with death.There were statistically significant differences between bad vs.good vs.indifferent prognosis in heart rate, shock index, leukocyte count, neutrophil count, NLR, hemoglobin, albumin, albumin/globulin, fasting blood glucose, blood urea nitrogen, serum creatinine, C-reactive protein(CRP)and CCI levels.Multivariate logistic regression analysis suggested that NLR≥13.18, fasting blood glucose ≥7.56 mmol/L, blood urea nitrogen ≥20.74 mmol/L, CRP≥65 mg/L and CCI≥3 might be predictors for in-hospital death in the cohort(OR=48.91、3.43、1.22、6.55、1.55, all P<0.05).
ConclusionsPulmonary infection is the most common reason for admission and the cause of death in centenarian inpatients.Comorbidities increase the risk of death.To lower in-hospital mortality, CCI and other assessment indicators should be used to strengthen the comprehensive assessment and chronic disease management of hospitalized centenarians.Infectious diseases should be prevented beforehand.
Key words:
Centenarians; Hospitalization; Pneumonia
Contributor Information
Wang Yu
Department of Geriatrics, Jiangsu Provincial Key Laboratory of Geriatrics, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
Song Weiwei
Department of Geriatrics, Jiangsu Provincial Key Laboratory of Geriatrics, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
Chen Xiaoli
Department of Respiratory Medicine, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing 210028, China
Wang Zhiyong
Department of Digestive Oncology, Jiangsu Province Hospital of Traditional Chinese Medicine, Nanjing 210029, China
Dai Jian
Department of Respiratory Medicine, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China
Ouyang Xiaojun
Department of Geriatrics, Jiangsu Province Geriatric Hospital, Nanjing 210024, China
Liu Lili
Department of Endocrinology, Zhongda Hospital Southeast University, Nanjing 210002, China
Liu Yu
Department of Geriatrics, Nanjing General Hospital, PLA, Nanjing 210029, China
Zhang Peng
Department of Neurology, the Second Affiliated Hospital of Nanjing Medical University, Nanjing 210011, China
Guo Zhaoling
Department of Emergency, Nanjing Center Hospital, Nanjing 210018, China
Wei Yunyan
Department of Respiratory Medicine, Nanjing First Hospital, Nanjing 210006, China
Chen Jihai
Department of Geriatrics, Jiangsu Province Geriatric Hospital, Nanjing 210024, China
Yuan Weiwei
Department of Geriatrics, Jiangsu Provincial Key Laboratory of Geriatrics, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
Zhao Weihong
Department of Geriatrics, Jiangsu Provincial Key Laboratory of Geriatrics, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
Wu Jianqing
Department of Geriatrics, Jiangsu Provincial Key Laboratory of Geriatrics, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
Xu Wei
Department of Geriatrics, Jiangsu Provincial Key Laboratory of Geriatrics, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China