Adverse consequences of hospitalization in the elderly. 1982

M R Gillick, and N A Serrell, and L S Gillick

This study prospectively examines 502 general medical patients for evidence of side-effect of hospitalization unrelated to diagnosis or therapy of acute illness. Symptoms of depressed psychophysiologic functioning (confusion, falling, not eating, and incontinence) unrelated to acute medical diagnoses were found in 8.8% of the patients under 70 and in 40.5% of the elderly population (P less than 0.0001). The rate of medical intervention secondary to these symptoms (psychotropic medications, restraints, nasogastric tubes, and foley catheters) was 37.9% among the young patients and 47.1% in the elderly group (P = 0.4). The sample was too small to permit adequate empirical determination of the complication rate from medical intervention (thrombophlebitis, pulmonary embolus, aspiration pneumonia, urinary tract infection, septic shock) but estimates from the literature indicate that each of the interventions studied entails a complication rate of 25-30%. Combining the observed rate of functional symptoms development and intervention, and the literature rates of complications, yields a risk of complications of 1.0% for the young and 5.7% for the elderly (P less than 0.0001). These data indicate that hospitalized elderly patients are at high risk of developing symptoms of depressed psychophysiology functioning and of sustaining medical intervention as a result of these symptoms, with attendant medical complications. We suggest that in incidence of depressed psychophysiologic function needs to be assessed in patients treated outside the hospital, along with efficacy of treatment outside the hospital, to determine whether there are patients for whom hospitalization is not optimal therapy.

UI MeSH Term Description Entries
D007049 Iatrogenic Disease Any adverse condition in a patient occurring as the result of treatment by a physician, surgeon, or other health professional, especially infections acquired by a patient during the course of treatment. Hospital-Acquired Condition,Condition, Hospital-Acquired,Conditions, Hospital-Acquired,Disease, Iatrogenic,Diseases, Iatrogenic,Hospital Acquired Condition,Hospital-Acquired Conditions,Iatrogenic Diseases
D011446 Prospective Studies Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group. Prospective Study,Studies, Prospective,Study, Prospective
D011602 Psychophysiologic Disorders A group of disorders characterized by physical symptoms that are affected by emotional factors and involve a single organ system, usually under AUTONOMIC NERVOUS SYSTEM control. (American Psychiatric Glossary, 1988) Psychosomatic Disorders,Psychophysiological Disorders,Psychophysiologic Disorder,Psychophysiological Disorder,Psychosomatic Disorder
D001900 Boston City located in Massachusetts.
D003221 Confusion A mental state characterized by bewilderment, emotional disturbance, lack of clear thinking, and perceptual disorientation. Confusional State,Bewilderment,Confusion, Post-Ictal,Confusion, Reactive,Disorientation,Confusion, Post Ictal,Confusional States,Post-Ictal Confusion,Reactive Confusion,State, Confusional,States, Confusional
D006746 Hospital Bed Capacity, 500 and over The number of beds 500 or more which a hospital has been designed and constructed to contain. It may also refer to the number of beds set up and staffed for use. Hospital Bed Capacity 500 Over
D006760 Hospitalization The confinement of a patient in a hospital. Hospitalizations
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D001068 Feeding and Eating Disorders A group of disorders characterized by physiological and psychological disturbances in appetite or food intake. Appetite Disorders,Eating Disorders,Eating and Feeding Disorders,Feeding Disorders,Appetite Disorder,Disorder, Eating,Disorder, Feeding,Disorders, Eating,Disorders, Feeding,Eating Disorder,Feeding Disorder

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