Systematic Review: Health-Related Characteristics of Elderly Hospitalized Adults and Nursing Home Residents Associated with Short-Term Mortality

Authors

  • John M. Thomas MD,

    Corresponding author
    1. Center of Excellence in Primary Care Education, Veterans Affairs Connecticut Healthcare System, West Haven, Connecticut
    • Department of Medicine, Yale University, New Haven, Connecticut
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  • Leo M. Cooney Jr. MD,

    1. Department of Medicine, Yale University, New Haven, Connecticut
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  • Terri R. Fried MD

    1. Department of Medicine, Yale University, New Haven, Connecticut
    2. Clinical Epidemiology Research Center, Veterans Affairs Connecticut Healthcare System, West Haven, Connecticut
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Address correspondence to John M. Thomas, 337 Crown St., New Haven, CT 06511. E-mail: john.thomas@yale.edu

Abstract

Objectives

To identify the domains of health-related characteristics of older hospitalized adults and nursing home residents most strongly associated with short-term mortality.

Design

Systematic review.

Setting

Studies published in English in MEDLINE, Scopus, or Web of Science before August 1, 2010.

Participants

Prospective studies consisting of persons aged 65 and older that evaluated the association between at least one health-related participant characteristic and mortality within a year in multivariable analysis.

Measurements

All health-related characteristics associated with mortality in multivariable analysis were extracted and categorized into domains. The frequency, with all studies combined, with which particular domains were associated with mortality in multivariable analysis was determined.

Results

Thirty-three studies (28 in hospitalized individuals, five in nursing home residents) reported a large number of characteristics associated with mortality that could be categorized in seven domains: cognitive function, disease diagnosis, laboratory values, nutrition, physical function, pressure ulcers, and shortness of breath. Measures of physical function and nutrition were the domains most frequently associated with mortality up to 1 year from the time of evaluation for hospitalized individuals and nursing home residents; measures of physical function, cognitive function, and nutrition were the domains most frequently associated with in-hospital mortality for hospitalized individuals.

Conclusion

Of a large number of health-related characteristics of older persons shown to be associated with short-term mortality, measures of nutrition, physical function, and cognitive function were the domains of health most frequently associated with mortality. These domains provide easily measurable factors that may serve as helpful markers for individuals at high mortality risk.

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