Predictive Factors of Post-Discharge Mortality in the Hospitalised Elderly

YH Ang, SF Wong, KM Chan
Correspondence: Dr Y H Ang

ABSTRACT
Aim To study the death rate of noninstitutionalised elderly after discharge from hospital, describe the causes of death and identify predictive factors of mortality.
Methods Vital status and cause of death of patients was ascertained by linkage to the death registry I year post discharge. Age, sex, race, marital status, housing and class of ward (to reflect socioeconomic status), presence of carer, Elderly Cognitive Assessment Questionnaire (ECAQ) score, Barthel score, presence of depression, number of chronic illnesses and length of stay in the hospital were studied as potential predictive factors for mortality using Cox proportional hazard regression models.
Results Death occurred in 38 out of 113 patients. The commonest causes of death were malignancy (18%) and cerebrovascular disease (18%). Barthel score and length of stay were independent significant predictive factors of mortality. Elderly with low ECAQ score, with carers and from C class wards also had higher mortality although these results were not statistically significant.
Conclusion Post-discharge mortality is high in the elderly. We recommend that further studies be done to determine if amelioration of these predictive factors would lead to decreased mortality or improvement of quality of life.

Keywords: predictive factors, mortality, geriatric, Barthel score, length of stay
Singapore Med J 2000; 41(3): 98-102