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Early Markers of Prolonged Hospital Stays in Older People: A Prospective, Multicenter Study of 908 Inpatients in French Acute Hospitals

Authors

  • Pierre-Olivier Lang MD,

    1. From the *Department of Internal Geriatric Medicine, Hôpital de la Robertsau, CHRU de Strasbourg, Strasbourg, FranceLaboratory of Epidemiology and Public Health, School of Medicine, Université de Strasbourg, Strasbourg, FranceSchool of Medicine, Université de Reims Champagne-Ardenne, E.A. 3797, Reims, France§Internal Medicine Unit and Geriatric Clinic, Hôpital Sébastopol, and Methodological Assistance Unit, Department of Medical Information, Hôpital Maison Blanche, CHU de Reims, Reims, FranceCenter of Gerontology, Hôpital Sainte Perrine, and #Division of Geriatrics, Hôpital Européen G. Pompidou, Assistance Publique—Hôpitaux de Paris, Paris, France**Center for Geriatric Medicine, Hôpital Porte Madeleine, CHR d'Orléans, Orléans, France††Geriatric Unit, Hôpital de la Tronche, CHU de Grenoble, Grenoble, France‡‡Internal Medicine Unit and Gerontology Clinic, Hôpital Rangueil, CHU de Toulouse, Toulouse, France§§Internal Medicine and Geriatrics Unit, Hôpital Gaston Doumergues, CHU de Nîmes, Nîmes, France∥∥Gerontology Clinic, Hôpital de la Charité, CHU de Saint Étienne, Saint Étienne, France¶¶Gerontology Clinic, Hôpital la Colombière, CHU de Montpellier, Montpellier, France.
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  • Damien Heitz MD,

    1. From the *Department of Internal Geriatric Medicine, Hôpital de la Robertsau, CHRU de Strasbourg, Strasbourg, FranceLaboratory of Epidemiology and Public Health, School of Medicine, Université de Strasbourg, Strasbourg, FranceSchool of Medicine, Université de Reims Champagne-Ardenne, E.A. 3797, Reims, France§Internal Medicine Unit and Geriatric Clinic, Hôpital Sébastopol, and Methodological Assistance Unit, Department of Medical Information, Hôpital Maison Blanche, CHU de Reims, Reims, FranceCenter of Gerontology, Hôpital Sainte Perrine, and #Division of Geriatrics, Hôpital Européen G. Pompidou, Assistance Publique—Hôpitaux de Paris, Paris, France**Center for Geriatric Medicine, Hôpital Porte Madeleine, CHR d'Orléans, Orléans, France††Geriatric Unit, Hôpital de la Tronche, CHU de Grenoble, Grenoble, France‡‡Internal Medicine Unit and Gerontology Clinic, Hôpital Rangueil, CHU de Toulouse, Toulouse, France§§Internal Medicine and Geriatrics Unit, Hôpital Gaston Doumergues, CHU de Nîmes, Nîmes, France∥∥Gerontology Clinic, Hôpital de la Charité, CHU de Saint Étienne, Saint Étienne, France¶¶Gerontology Clinic, Hôpital la Colombière, CHU de Montpellier, Montpellier, France.
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  • Guy Hédelin PhD,

    1. From the *Department of Internal Geriatric Medicine, Hôpital de la Robertsau, CHRU de Strasbourg, Strasbourg, FranceLaboratory of Epidemiology and Public Health, School of Medicine, Université de Strasbourg, Strasbourg, FranceSchool of Medicine, Université de Reims Champagne-Ardenne, E.A. 3797, Reims, France§Internal Medicine Unit and Geriatric Clinic, Hôpital Sébastopol, and Methodological Assistance Unit, Department of Medical Information, Hôpital Maison Blanche, CHU de Reims, Reims, FranceCenter of Gerontology, Hôpital Sainte Perrine, and #Division of Geriatrics, Hôpital Européen G. Pompidou, Assistance Publique—Hôpitaux de Paris, Paris, France**Center for Geriatric Medicine, Hôpital Porte Madeleine, CHR d'Orléans, Orléans, France††Geriatric Unit, Hôpital de la Tronche, CHU de Grenoble, Grenoble, France‡‡Internal Medicine Unit and Gerontology Clinic, Hôpital Rangueil, CHU de Toulouse, Toulouse, France§§Internal Medicine and Geriatrics Unit, Hôpital Gaston Doumergues, CHU de Nîmes, Nîmes, France∥∥Gerontology Clinic, Hôpital de la Charité, CHU de Saint Étienne, Saint Étienne, France¶¶Gerontology Clinic, Hôpital la Colombière, CHU de Montpellier, Montpellier, France.
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  • Moustapha Dramé MD,

    1. From the *Department of Internal Geriatric Medicine, Hôpital de la Robertsau, CHRU de Strasbourg, Strasbourg, FranceLaboratory of Epidemiology and Public Health, School of Medicine, Université de Strasbourg, Strasbourg, FranceSchool of Medicine, Université de Reims Champagne-Ardenne, E.A. 3797, Reims, France§Internal Medicine Unit and Geriatric Clinic, Hôpital Sébastopol, and Methodological Assistance Unit, Department of Medical Information, Hôpital Maison Blanche, CHU de Reims, Reims, FranceCenter of Gerontology, Hôpital Sainte Perrine, and #Division of Geriatrics, Hôpital Européen G. Pompidou, Assistance Publique—Hôpitaux de Paris, Paris, France**Center for Geriatric Medicine, Hôpital Porte Madeleine, CHR d'Orléans, Orléans, France††Geriatric Unit, Hôpital de la Tronche, CHU de Grenoble, Grenoble, France‡‡Internal Medicine Unit and Gerontology Clinic, Hôpital Rangueil, CHU de Toulouse, Toulouse, France§§Internal Medicine and Geriatrics Unit, Hôpital Gaston Doumergues, CHU de Nîmes, Nîmes, France∥∥Gerontology Clinic, Hôpital de la Charité, CHU de Saint Étienne, Saint Étienne, France¶¶Gerontology Clinic, Hôpital la Colombière, CHU de Montpellier, Montpellier, France.
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  • Nicolas Jovenin MD,

    1. From the *Department of Internal Geriatric Medicine, Hôpital de la Robertsau, CHRU de Strasbourg, Strasbourg, FranceLaboratory of Epidemiology and Public Health, School of Medicine, Université de Strasbourg, Strasbourg, FranceSchool of Medicine, Université de Reims Champagne-Ardenne, E.A. 3797, Reims, France§Internal Medicine Unit and Geriatric Clinic, Hôpital Sébastopol, and Methodological Assistance Unit, Department of Medical Information, Hôpital Maison Blanche, CHU de Reims, Reims, FranceCenter of Gerontology, Hôpital Sainte Perrine, and #Division of Geriatrics, Hôpital Européen G. Pompidou, Assistance Publique—Hôpitaux de Paris, Paris, France**Center for Geriatric Medicine, Hôpital Porte Madeleine, CHR d'Orléans, Orléans, France††Geriatric Unit, Hôpital de la Tronche, CHU de Grenoble, Grenoble, France‡‡Internal Medicine Unit and Gerontology Clinic, Hôpital Rangueil, CHU de Toulouse, Toulouse, France§§Internal Medicine and Geriatrics Unit, Hôpital Gaston Doumergues, CHU de Nîmes, Nîmes, France∥∥Gerontology Clinic, Hôpital de la Charité, CHU de Saint Étienne, Saint Étienne, France¶¶Gerontology Clinic, Hôpital la Colombière, CHU de Montpellier, Montpellier, France.
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  • Joël Ankri MD, PhD,

    1. From the *Department of Internal Geriatric Medicine, Hôpital de la Robertsau, CHRU de Strasbourg, Strasbourg, FranceLaboratory of Epidemiology and Public Health, School of Medicine, Université de Strasbourg, Strasbourg, FranceSchool of Medicine, Université de Reims Champagne-Ardenne, E.A. 3797, Reims, France§Internal Medicine Unit and Geriatric Clinic, Hôpital Sébastopol, and Methodological Assistance Unit, Department of Medical Information, Hôpital Maison Blanche, CHU de Reims, Reims, FranceCenter of Gerontology, Hôpital Sainte Perrine, and #Division of Geriatrics, Hôpital Européen G. Pompidou, Assistance Publique—Hôpitaux de Paris, Paris, France**Center for Geriatric Medicine, Hôpital Porte Madeleine, CHR d'Orléans, Orléans, France††Geriatric Unit, Hôpital de la Tronche, CHU de Grenoble, Grenoble, France‡‡Internal Medicine Unit and Gerontology Clinic, Hôpital Rangueil, CHU de Toulouse, Toulouse, France§§Internal Medicine and Geriatrics Unit, Hôpital Gaston Doumergues, CHU de Nîmes, Nîmes, France∥∥Gerontology Clinic, Hôpital de la Charité, CHU de Saint Étienne, Saint Étienne, France¶¶Gerontology Clinic, Hôpital la Colombière, CHU de Montpellier, Montpellier, France.
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  • Dominique Somme MD,

    1. From the *Department of Internal Geriatric Medicine, Hôpital de la Robertsau, CHRU de Strasbourg, Strasbourg, FranceLaboratory of Epidemiology and Public Health, School of Medicine, Université de Strasbourg, Strasbourg, FranceSchool of Medicine, Université de Reims Champagne-Ardenne, E.A. 3797, Reims, France§Internal Medicine Unit and Geriatric Clinic, Hôpital Sébastopol, and Methodological Assistance Unit, Department of Medical Information, Hôpital Maison Blanche, CHU de Reims, Reims, FranceCenter of Gerontology, Hôpital Sainte Perrine, and #Division of Geriatrics, Hôpital Européen G. Pompidou, Assistance Publique—Hôpitaux de Paris, Paris, France**Center for Geriatric Medicine, Hôpital Porte Madeleine, CHR d'Orléans, Orléans, France††Geriatric Unit, Hôpital de la Tronche, CHU de Grenoble, Grenoble, France‡‡Internal Medicine Unit and Gerontology Clinic, Hôpital Rangueil, CHU de Toulouse, Toulouse, France§§Internal Medicine and Geriatrics Unit, Hôpital Gaston Doumergues, CHU de Nîmes, Nîmes, France∥∥Gerontology Clinic, Hôpital de la Charité, CHU de Saint Étienne, Saint Étienne, France¶¶Gerontology Clinic, Hôpital la Colombière, CHU de Montpellier, Montpellier, France.
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  • Jean-Luc Novella MD, PhD,

    1. From the *Department of Internal Geriatric Medicine, Hôpital de la Robertsau, CHRU de Strasbourg, Strasbourg, FranceLaboratory of Epidemiology and Public Health, School of Medicine, Université de Strasbourg, Strasbourg, FranceSchool of Medicine, Université de Reims Champagne-Ardenne, E.A. 3797, Reims, France§Internal Medicine Unit and Geriatric Clinic, Hôpital Sébastopol, and Methodological Assistance Unit, Department of Medical Information, Hôpital Maison Blanche, CHU de Reims, Reims, FranceCenter of Gerontology, Hôpital Sainte Perrine, and #Division of Geriatrics, Hôpital Européen G. Pompidou, Assistance Publique—Hôpitaux de Paris, Paris, France**Center for Geriatric Medicine, Hôpital Porte Madeleine, CHR d'Orléans, Orléans, France††Geriatric Unit, Hôpital de la Tronche, CHU de Grenoble, Grenoble, France‡‡Internal Medicine Unit and Gerontology Clinic, Hôpital Rangueil, CHU de Toulouse, Toulouse, France§§Internal Medicine and Geriatrics Unit, Hôpital Gaston Doumergues, CHU de Nîmes, Nîmes, France∥∥Gerontology Clinic, Hôpital de la Charité, CHU de Saint Étienne, Saint Étienne, France¶¶Gerontology Clinic, Hôpital la Colombière, CHU de Montpellier, Montpellier, France.
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  • Jean Bernard Gauvain MD,

    1. From the *Department of Internal Geriatric Medicine, Hôpital de la Robertsau, CHRU de Strasbourg, Strasbourg, FranceLaboratory of Epidemiology and Public Health, School of Medicine, Université de Strasbourg, Strasbourg, FranceSchool of Medicine, Université de Reims Champagne-Ardenne, E.A. 3797, Reims, France§Internal Medicine Unit and Geriatric Clinic, Hôpital Sébastopol, and Methodological Assistance Unit, Department of Medical Information, Hôpital Maison Blanche, CHU de Reims, Reims, FranceCenter of Gerontology, Hôpital Sainte Perrine, and #Division of Geriatrics, Hôpital Européen G. Pompidou, Assistance Publique—Hôpitaux de Paris, Paris, France**Center for Geriatric Medicine, Hôpital Porte Madeleine, CHR d'Orléans, Orléans, France††Geriatric Unit, Hôpital de la Tronche, CHU de Grenoble, Grenoble, France‡‡Internal Medicine Unit and Gerontology Clinic, Hôpital Rangueil, CHU de Toulouse, Toulouse, France§§Internal Medicine and Geriatrics Unit, Hôpital Gaston Doumergues, CHU de Nîmes, Nîmes, France∥∥Gerontology Clinic, Hôpital de la Charité, CHU de Saint Étienne, Saint Étienne, France¶¶Gerontology Clinic, Hôpital la Colombière, CHU de Montpellier, Montpellier, France.
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  • Pascal Couturier MD,

    1. From the *Department of Internal Geriatric Medicine, Hôpital de la Robertsau, CHRU de Strasbourg, Strasbourg, FranceLaboratory of Epidemiology and Public Health, School of Medicine, Université de Strasbourg, Strasbourg, FranceSchool of Medicine, Université de Reims Champagne-Ardenne, E.A. 3797, Reims, France§Internal Medicine Unit and Geriatric Clinic, Hôpital Sébastopol, and Methodological Assistance Unit, Department of Medical Information, Hôpital Maison Blanche, CHU de Reims, Reims, FranceCenter of Gerontology, Hôpital Sainte Perrine, and #Division of Geriatrics, Hôpital Européen G. Pompidou, Assistance Publique—Hôpitaux de Paris, Paris, France**Center for Geriatric Medicine, Hôpital Porte Madeleine, CHR d'Orléans, Orléans, France††Geriatric Unit, Hôpital de la Tronche, CHU de Grenoble, Grenoble, France‡‡Internal Medicine Unit and Gerontology Clinic, Hôpital Rangueil, CHU de Toulouse, Toulouse, France§§Internal Medicine and Geriatrics Unit, Hôpital Gaston Doumergues, CHU de Nîmes, Nîmes, France∥∥Gerontology Clinic, Hôpital de la Charité, CHU de Saint Étienne, Saint Étienne, France¶¶Gerontology Clinic, Hôpital la Colombière, CHU de Montpellier, Montpellier, France.
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  • Thierry Voisin MD,

    1. From the *Department of Internal Geriatric Medicine, Hôpital de la Robertsau, CHRU de Strasbourg, Strasbourg, FranceLaboratory of Epidemiology and Public Health, School of Medicine, Université de Strasbourg, Strasbourg, FranceSchool of Medicine, Université de Reims Champagne-Ardenne, E.A. 3797, Reims, France§Internal Medicine Unit and Geriatric Clinic, Hôpital Sébastopol, and Methodological Assistance Unit, Department of Medical Information, Hôpital Maison Blanche, CHU de Reims, Reims, FranceCenter of Gerontology, Hôpital Sainte Perrine, and #Division of Geriatrics, Hôpital Européen G. Pompidou, Assistance Publique—Hôpitaux de Paris, Paris, France**Center for Geriatric Medicine, Hôpital Porte Madeleine, CHR d'Orléans, Orléans, France††Geriatric Unit, Hôpital de la Tronche, CHU de Grenoble, Grenoble, France‡‡Internal Medicine Unit and Gerontology Clinic, Hôpital Rangueil, CHU de Toulouse, Toulouse, France§§Internal Medicine and Geriatrics Unit, Hôpital Gaston Doumergues, CHU de Nîmes, Nîmes, France∥∥Gerontology Clinic, Hôpital de la Charité, CHU de Saint Étienne, Saint Étienne, France¶¶Gerontology Clinic, Hôpital la Colombière, CHU de Montpellier, Montpellier, France.
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  • Benoît De Wazière MD, PhD,

    1. From the *Department of Internal Geriatric Medicine, Hôpital de la Robertsau, CHRU de Strasbourg, Strasbourg, FranceLaboratory of Epidemiology and Public Health, School of Medicine, Université de Strasbourg, Strasbourg, FranceSchool of Medicine, Université de Reims Champagne-Ardenne, E.A. 3797, Reims, France§Internal Medicine Unit and Geriatric Clinic, Hôpital Sébastopol, and Methodological Assistance Unit, Department of Medical Information, Hôpital Maison Blanche, CHU de Reims, Reims, FranceCenter of Gerontology, Hôpital Sainte Perrine, and #Division of Geriatrics, Hôpital Européen G. Pompidou, Assistance Publique—Hôpitaux de Paris, Paris, France**Center for Geriatric Medicine, Hôpital Porte Madeleine, CHR d'Orléans, Orléans, France††Geriatric Unit, Hôpital de la Tronche, CHU de Grenoble, Grenoble, France‡‡Internal Medicine Unit and Gerontology Clinic, Hôpital Rangueil, CHU de Toulouse, Toulouse, France§§Internal Medicine and Geriatrics Unit, Hôpital Gaston Doumergues, CHU de Nîmes, Nîmes, France∥∥Gerontology Clinic, Hôpital de la Charité, CHU de Saint Étienne, Saint Étienne, France¶¶Gerontology Clinic, Hôpital la Colombière, CHU de Montpellier, Montpellier, France.
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  • Régis Gonthier MD, PhD,

    1. From the *Department of Internal Geriatric Medicine, Hôpital de la Robertsau, CHRU de Strasbourg, Strasbourg, FranceLaboratory of Epidemiology and Public Health, School of Medicine, Université de Strasbourg, Strasbourg, FranceSchool of Medicine, Université de Reims Champagne-Ardenne, E.A. 3797, Reims, France§Internal Medicine Unit and Geriatric Clinic, Hôpital Sébastopol, and Methodological Assistance Unit, Department of Medical Information, Hôpital Maison Blanche, CHU de Reims, Reims, FranceCenter of Gerontology, Hôpital Sainte Perrine, and #Division of Geriatrics, Hôpital Européen G. Pompidou, Assistance Publique—Hôpitaux de Paris, Paris, France**Center for Geriatric Medicine, Hôpital Porte Madeleine, CHR d'Orléans, Orléans, France††Geriatric Unit, Hôpital de la Tronche, CHU de Grenoble, Grenoble, France‡‡Internal Medicine Unit and Gerontology Clinic, Hôpital Rangueil, CHU de Toulouse, Toulouse, France§§Internal Medicine and Geriatrics Unit, Hôpital Gaston Doumergues, CHU de Nîmes, Nîmes, France∥∥Gerontology Clinic, Hôpital de la Charité, CHU de Saint Étienne, Saint Étienne, France¶¶Gerontology Clinic, Hôpital la Colombière, CHU de Montpellier, Montpellier, France.
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  • Claude Jeandel MD, PhD,

    1. From the *Department of Internal Geriatric Medicine, Hôpital de la Robertsau, CHRU de Strasbourg, Strasbourg, FranceLaboratory of Epidemiology and Public Health, School of Medicine, Université de Strasbourg, Strasbourg, FranceSchool of Medicine, Université de Reims Champagne-Ardenne, E.A. 3797, Reims, France§Internal Medicine Unit and Geriatric Clinic, Hôpital Sébastopol, and Methodological Assistance Unit, Department of Medical Information, Hôpital Maison Blanche, CHU de Reims, Reims, FranceCenter of Gerontology, Hôpital Sainte Perrine, and #Division of Geriatrics, Hôpital Européen G. Pompidou, Assistance Publique—Hôpitaux de Paris, Paris, France**Center for Geriatric Medicine, Hôpital Porte Madeleine, CHR d'Orléans, Orléans, France††Geriatric Unit, Hôpital de la Tronche, CHU de Grenoble, Grenoble, France‡‡Internal Medicine Unit and Gerontology Clinic, Hôpital Rangueil, CHU de Toulouse, Toulouse, France§§Internal Medicine and Geriatrics Unit, Hôpital Gaston Doumergues, CHU de Nîmes, Nîmes, France∥∥Gerontology Clinic, Hôpital de la Charité, CHU de Saint Étienne, Saint Étienne, France¶¶Gerontology Clinic, Hôpital la Colombière, CHU de Montpellier, Montpellier, France.
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  • Damien Jolly MD, PhD,

    1. From the *Department of Internal Geriatric Medicine, Hôpital de la Robertsau, CHRU de Strasbourg, Strasbourg, FranceLaboratory of Epidemiology and Public Health, School of Medicine, Université de Strasbourg, Strasbourg, FranceSchool of Medicine, Université de Reims Champagne-Ardenne, E.A. 3797, Reims, France§Internal Medicine Unit and Geriatric Clinic, Hôpital Sébastopol, and Methodological Assistance Unit, Department of Medical Information, Hôpital Maison Blanche, CHU de Reims, Reims, FranceCenter of Gerontology, Hôpital Sainte Perrine, and #Division of Geriatrics, Hôpital Européen G. Pompidou, Assistance Publique—Hôpitaux de Paris, Paris, France**Center for Geriatric Medicine, Hôpital Porte Madeleine, CHR d'Orléans, Orléans, France††Geriatric Unit, Hôpital de la Tronche, CHU de Grenoble, Grenoble, France‡‡Internal Medicine Unit and Gerontology Clinic, Hôpital Rangueil, CHU de Toulouse, Toulouse, France§§Internal Medicine and Geriatrics Unit, Hôpital Gaston Doumergues, CHU de Nîmes, Nîmes, France∥∥Gerontology Clinic, Hôpital de la Charité, CHU de Saint Étienne, Saint Étienne, France¶¶Gerontology Clinic, Hôpital la Colombière, CHU de Montpellier, Montpellier, France.
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  • Olivier Saint-Jean MD, PhD,

    1. From the *Department of Internal Geriatric Medicine, Hôpital de la Robertsau, CHRU de Strasbourg, Strasbourg, FranceLaboratory of Epidemiology and Public Health, School of Medicine, Université de Strasbourg, Strasbourg, FranceSchool of Medicine, Université de Reims Champagne-Ardenne, E.A. 3797, Reims, France§Internal Medicine Unit and Geriatric Clinic, Hôpital Sébastopol, and Methodological Assistance Unit, Department of Medical Information, Hôpital Maison Blanche, CHU de Reims, Reims, FranceCenter of Gerontology, Hôpital Sainte Perrine, and #Division of Geriatrics, Hôpital Européen G. Pompidou, Assistance Publique—Hôpitaux de Paris, Paris, France**Center for Geriatric Medicine, Hôpital Porte Madeleine, CHR d'Orléans, Orléans, France††Geriatric Unit, Hôpital de la Tronche, CHU de Grenoble, Grenoble, France‡‡Internal Medicine Unit and Gerontology Clinic, Hôpital Rangueil, CHU de Toulouse, Toulouse, France§§Internal Medicine and Geriatrics Unit, Hôpital Gaston Doumergues, CHU de Nîmes, Nîmes, France∥∥Gerontology Clinic, Hôpital de la Charité, CHU de Saint Étienne, Saint Étienne, France¶¶Gerontology Clinic, Hôpital la Colombière, CHU de Montpellier, Montpellier, France.
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  • François Blanchard MD, PhD

    1. From the *Department of Internal Geriatric Medicine, Hôpital de la Robertsau, CHRU de Strasbourg, Strasbourg, FranceLaboratory of Epidemiology and Public Health, School of Medicine, Université de Strasbourg, Strasbourg, FranceSchool of Medicine, Université de Reims Champagne-Ardenne, E.A. 3797, Reims, France§Internal Medicine Unit and Geriatric Clinic, Hôpital Sébastopol, and Methodological Assistance Unit, Department of Medical Information, Hôpital Maison Blanche, CHU de Reims, Reims, FranceCenter of Gerontology, Hôpital Sainte Perrine, and #Division of Geriatrics, Hôpital Européen G. Pompidou, Assistance Publique—Hôpitaux de Paris, Paris, France**Center for Geriatric Medicine, Hôpital Porte Madeleine, CHR d'Orléans, Orléans, France††Geriatric Unit, Hôpital de la Tronche, CHU de Grenoble, Grenoble, France‡‡Internal Medicine Unit and Gerontology Clinic, Hôpital Rangueil, CHU de Toulouse, Toulouse, France§§Internal Medicine and Geriatrics Unit, Hôpital Gaston Doumergues, CHU de Nîmes, Nîmes, France∥∥Gerontology Clinic, Hôpital de la Charité, CHU de Saint Étienne, Saint Étienne, France¶¶Gerontology Clinic, Hôpital la Colombière, CHU de Montpellier, Montpellier, France.
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Errata

This article is corrected by:

  1. Errata: ERRATUM Volume 54, Issue 9, 1479–1480, Article first published online: 7 September 2006

Address correspondence to Pierre-Olivier Lang, MD, Pole de Gériatrie du CHRU de Strasbourg, Service de Médecine Interne Gériatrique, Hôpital de la Robertsau, 83 rue Himmerich, 67091 Strasbourg Cedex, France. E-mail: Pierre-Olivier.LANG@chru-strasbourg.fr

Abstract

OBJECTIVES: To identify early markers of prolonged hospital stays in older people in acute hospitals.

DESIGN: A prospective, multicenter study.

SETTING: Nine hospitals in France.

PARTICIPANTS: One thousand three hundred six patients aged 75 and older were hospitalized through an emergency department (Sujet Âgé Fragile: Évaluation et suivi (SAFEs) —Frail Elderly Subjects: Evaluation and follow-up).

MEASUREMENTS: Data used in a logistic regression were obtained through a gerontological evaluation of inpatients, conducted in the first week of hospitalization. The center effect was considered in two models as a random and fixed effect. Two limits were used to define a prolonged hospital stay. The first was fixed at 30 days. The second was adjusted for Diagnosis Related Groups according to the French classification (f-DRG).

RESULTS: Nine hundred eight of the 1,306 hospital stays that made up the cohort were analyzed. Two centers (n=298) were excluded because of a large volume of missing f-DRGs. Two-thirds of subjects in the cohort analyzed were women (64%), with a mean age of 84. One hundred thirty-eight stays (15%) lasted more than 30 days; 46 (5%) were prolonged beyond the f-DRG-adjusted limit. No sociodemographic variables seemed to influence the length of stay, regardless of the limit used. For the 30-day limit, only cognitive impairment (odds ratio (OR)=2.2, 95% confidence interval (CI)=1.2–4.0) was identified as a marker for prolongation. f-DRG adjustment revealed other clinical markers. Walking difficulties (OR=2.6, 95% CI=1.2–16.7), fall risk (OR=2.5, 95% CI=1.7–5.3), cognitive impairment (OR=7.1, 95% CI=2.3–49.9), and malnutrition risk (OR=2.5, 95% CI=1.7–19.6) were found to be early markers for prolonged stays, although dependence level and its evolution, estimated using the Katz activity of daily living (ADL) index, were not identified as risk factors.

CONCLUSION: When the generally recognized parameters of frailty are taken into account, a set of simple items (walking difficulties, risk of fall, risk of malnutrition, and cognitive impairment) enables a predictive approach to the length of stay of elderly patients hospitalized under emergency circumstances. Katz ADLs were not among the early markers identified.

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