Who is at risk of long hospital stay among patients admitted to geriatric acute care unit? Results from a prospective cohort study

• Published in: The Journal of nutrition, health & aging Vol. 17; no. 8; pp. 695 - 699
• Main Authors: Beauchet, Olivier, Launay, C, De Decker, L, Fantino, B, Kabeshova, A, Annweiler, C
• Format: Journal Article
• Language: English
• Published: Paris Springer-Verlag 2013; Springer Paris; Serdi; Springer; Springer Nature B.V; Springer Verlag (Germany)
• Subjects: Aged; Aged, 80 and over; Aging; Biological and medical sciences; blood serum; Chronic illnesses; Cohort analysis; cohort studies; Critical Care; Delirium; Delirium - complications; experimental design; Feeding. Feeding behavior; Female; France; Fundamental and applied biological sciences. Psychology; Gender; Geriatrics; Geriatrics/Gerontology; Hospital Units; Hospitals; Humanities and Social Sciences; Humans; Kaplan-Meier Estimate; Length of Stay; Linear Models; Male; Medicine; Medicine & Public Health; Neurosciences; Nutrition; Odds Ratio; patients; Primary Care Medicine; Prospective Studies; Quality of Life Research; regression analysis; risk; Risk Factors; Sex Factors; Standard deviation; Vertebrates: anatomy and physiology, studies on body, several organs or systems; Vitamin D; vitamin D deficiency; Vitamin D Deficiency - blood; Vitamin D Deficiency - complications; Vitamin deficiency; women; France; length of stay; risk factors; Aged; patient care; inpatient; vitamin D; Human; Long stay; Acute; Metabolic diseases; Risk; Duration; Care; Prospective; Vitamin D; Cohort study; Risk factor; Hospital; Geriatrics; WHO; functional decline; Length of Stay; screening instruments; metaanalysis; Risk Factors; people; Morbidity; Inpatients; vitamin-d; older-adults; illness
• ISSN: 1279-7707; 1760-4788
• DOI: 10.1007/s12603-013-0333-z

OBJECTIVE: 1) To confirm that vitamin D deficiency, defined as serum 25-hydroxyvitamin D (25OHD) concentration < 25nmol/L, was associated with long length-of-stay (LOS) among older inpatients admitted to geriatric acute care unit; and 2) to examine which combination of risk factors of longer LOS including vitamin D deficiency best predicted longer LOS. STUDY DESIGN AND SETTING: Based on a prospective cohort study with a 25-day follow-up on average, 531 consecutive older inpatients (mean age 85.0±7.2 years, 59.1% women) admitted to the geriatric acute care unit of Angers University Hospital, France, were included. RESULTS: Linear regression models showed that male gender (P<0.025), delirium (P<0.015) and vitamin D deficiency (P<0.001) were independently associated with a longer LOS. The highest risk of a longer LOS was shown while combining vitamin D deficiency with male gender (Odds ratio (OR)=3.70 with P<0.001). The risk increased significantly while delirium was associated with these two baseline characteristics (OR=4.76 with P=0.001). Kaplan-Meier distributions of discharge differed significantly between participants who had or not the combination of the 3 criteria (P<0.007). CONCLUSIONS: Vitamin D deficiency, delirium and male gender were significant risk factors for a longer LOS in the studied sample of older inpatients.