[Nonagenarians on an emergency department for internal medicine and cardiology : Comparison of comorbidities, disease course and survival with younger patients].

IF 1 4区医学 Q4 GERIATRICS & GERONTOLOGY

Zeitschrift Fur Gerontologie Und Geriatrie Pub Date : 2025-10-01 Epub Date: 2024-12-28 DOI:10.1007/s00391-024-02389-y

Lisa-Maria Sow, Claudia Stöllberger, Patrick Lazarevic, Simon Udovica, Franz Weidinger

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引用次数: 0

Abstract

Background: Little is known about how younger and older hospitalized patients differ with respect to reasons for admission, comorbidities, diagnostics, treatment and intercurrent problems.

Objective: The aim of the study was to compare the previously named characteristics in the clinical profile of patients > 90 years old (nonagenarians) with a control group of patients 70-75 years old admitted to an emergency hospital department for internal medicine and cardiology.

Material and method: The study included all consecutive nonagenarians and gender-matched control patients who were admitted during 2011. The reason for admission, comorbidities, diagnostics, treatment, intercurrent problems and discharge medication were taken from the patient records. Data on 8‑year mortality were obtained by comparison of the death data.

Results: Nonagenarians (n = 117; 81 females) had a mean age of 92 ± 2.5 years and the control patients 72 ± 1.6 years. Nonagenarians were hospitalized more often because of neurological symptoms (19% vs. 7%), suffered more from kidney failure (85% vs. 67%), heart failure (35% vs. 21%), malignancies (29% vs. 8%), dementia (28% vs. 4%) and stroke (15% vs. 6%), developed confusion more often (27% vs. 7%) and fell more often (15% vs. 0%) than control patients. Control patients had a higher body mass index (29 ± 5.3 vs. 24 ± 4.1). Nonagenarians received fewer diagnostic measures (1.6 vs. 2.3), more often intravenous fluid (77% vs. 51%), diuretics (31% vs. 18%) and physiotherapy (24% vs. 8%). Polypharmacy (> 5 medications) in the discharge letter was frequent in both groups (67% vs. 75%). The yearly mortality of the nonagenarians was 27% and of the control group 6%.

Conclusion: Acute internal diseases in nonagenarians are frequently manifested with neurological symptoms. In hospitalized nonagenarians, prevention of falls and delirium are of clinical relevance. Polypharmacy is a relevant problem in nonagenarians as well as in control patients.

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[内科和心脏病急诊科的老年患者：与年轻患者的合并症、病程和生存率的比较]。

背景：关于年轻和老年住院患者在入院原因、合并症、诊断、治疗和并发问题方面的差异，我们知之甚少。目的：该研究的目的是比较先前在医院急诊科住院的 b> 90岁（90岁以上）患者的临床资料中命名的特征与对照组的70-75岁的内科和心脏病患者。材料与方法：本研究纳入2011年入院的所有连续的90岁以上老年人和性别匹配的对照患者。入院原因、合并症、诊断、治疗、并发问题和出院用药均取自患者记录。通过比较死亡数据获得8年死亡率数据。结果：老年人(n = 117；女性81例，平均年龄92 ±2.5岁，对照组72 ±1.6岁。与对照组相比，老年患者因神经系统症状住院的频率更高（19%对7%），患肾衰竭的频率更高（85%对67%），心力衰竭的频率更高（35%对21%），恶性肿瘤的频率更高（29%对8%），痴呆的频率更高（28%对4%），中风的频率更高（15%对6%），精神错乱的频率更高（27%对7%），跌倒的频率更高（15%对0%）。对照组患者的体重指数较高（29 ±5.3 vs. 24 ±4.1）。老年人接受较少的诊断措施（1.6对2.3），更常见的是静脉输液（77%对51%）、利尿剂（31%对18%）和物理治疗（24%对8%）。出院信中多药（> 5种药物）在两组中都很常见（67%对75%）。90岁以上老人的年死亡率为27%，对照组为6%。结论：老年急性内科疾病多表现为神经系统症状。在住院的90岁老人中，预防跌倒和谵妄具有临床意义。多药是一个相关的问题，在老年和对照患者。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Zeitschrift Fur Gerontologie Und Geriatrie 医学-老年医学

CiteScore

2.00

自引率

16.70%

发文量

126

审稿时长

6-12 weeks

期刊介绍： The fact that more and more people are becoming older and are having a significant influence on our society is due to intensive geriatric research and geriatric medicine in the past and present. The Zeitschrift für Gerontologie und Geriatrie has contributed to this area for many years by informing a broad spectrum of interested readers about various developments in gerontology research. Special issues focus on all questions concerning gerontology, biology and basic research of aging, geriatric research, psychology and sociology as well as practical aspects of geriatric care. Target group: Geriatricians, social gerontologists, geriatric psychologists, geriatric psychiatrists, nurses/caregivers, nurse researchers, biogerontologists in geriatric wards/clinics, gerontological institutes, and institutions of teaching and further or continuing education.