Predictors of In-hospital Mortality in Oldest-Old Patients in Taiwan

Background: Elderly adults are at a higher risk of complications during their hospital stay and have a higher in-hospital mortality rate. The aim of this study was to analyze the risk factors associated with mortality in the oldest-old patients admitted to a large teaching hospital in Taiwan. Methods: All study participants, aged more than 75 years, were recruited from the unselected acutely ill patients admitted to our hospital between March and July 2009. Results: A total of 3945 admissions were included. Out of these, 2037 (51.6%) patients were female and the average age was 81.8 (+/- 5.4) years. The overall in-hospital mortality rate was 8.2% (9.9% in medical wards; 3.7% in surgical wards). The main predictors for in-hospital mortality in medical wards were advanced age >80 years [odds ratio (OR), 1.83 (1.25-2.68)], plasma glucose at admission >160 or <80 mg/dL [OR, 1.97 (1.36-2.85)], alanine aminotransferase >80 U/L [OR, 2.78 (1.68-4.58)], creatinine >1.5 mg/dL [OR, 2.91 (2.06-4.12)1, white cell count >12 x 10(3) or <3 x 10(3)/mu L [OR, 2.59 (1.84-3.65)], and abnormal blood pressure >180 or <90 mmHg [OR, 2.29 (131-3.99)]. Abnormal levels of hemoglobin (<9 g/dL), white cell count, and being transferred from the emergency room were significantly related to in-hospital mortality in surgical wards. Conclusions: Our findings suggest that particular attention should be paid to patients with an older age, those with abnormal levels of routine admission tests, or those being referred from an emergency room, which indicates critical health conditions, and higher in-hospital mortality. Copyright (C) 2012, Taiwan Society of Geriatric Emergency & Critical Care Medicine. Published by Elsevier Taiwan LLC. All rights reserved.