Factors Determining Mortality in Geriatric Palliative Care Patients

Abstract

Background: As life expectancy at birth increases, the elderly population is growing, both in Turkey and globally. The aim of this study was to investigate the factors associated with 12-month mortality in patients receiving geriatric palliative care. Methods: Geriatric inpatients who were treated for 48 hours or more in the palliative care unit of our hospital between January 2016 and January 2017 were included in the study. Results: A total of 233 geriatric palliative care patients (50.6% women) with a mean age of 77.6 ± 11.0 were included in the study. Eighty of the patients in our study died while in palliative care. Chronic kidney disease (CKD) and chronic obstructive pulmonary disease (COPD) were significantly more common among the deceased patients. Of the 153 surviving patients, 94 (61.4%) died within 12 months of discharge and 59 (38.6%) survived beyond 12 months. Presence of CKD was associated with a 2.17-fold reduction in survival time and albumin level ＜ 3.2 mg/L with 2.12-fold reduction in survival time. In addition, post-discharge 12-month survival time was 1.80-fold shorter in the presence of solid organ malignancy, 2.06-fold shorter with APACHE-II score ＞ 20.5, 1.60-fold shorter with Charlson Comorbidity Index (CCI) ＞ 6.5, and 1.98-fold shorter with albumin levels ＜ 3.2 mg/L. Conclusion: CKD and low albumin were identified as independent risk factors for reduced hospital survival time. Independent risk factors for shorter post-discharge survival time included the presence of solid organ malignancy, high APACHE-II score, high CCI, and low albumin level.