Survival of elderly outpatients: effects of frailty, multimorbidity and disability

• Published in: Ciência & saude coletiva Vol. 24; no. 1; pp. 137 - 146
• Main Authors: Leme, Daniel Eduardo da Cunha, Thomaz, Raquel Prado, Borim, Flávia Silvia Arbex, Brenelli, Sigisfredo Luiz, Oliveira, Daniel Vicentini de, Fattori, André
• Format: Journal Article
• Language: Portuguese; English
• Published: Brazil Associacao Brasileira de Pos-Graduacao em Saude Coletiva - ABRASCO 01.01.2019
• ISSN: 1413-8123; 1678-4561
• DOI: 10.1590/1413-81232018241.04952017

This study aims to analyze the impact of frailty, multimorbidity and disability on the survival of elderly people attended in a geriatric outpatient facility, and identify the clinical risk factors associated with death. It is a longitudinal study, with 133 elderly people initially evaluated in relation to frailty, multimorbidity (simultaneous presence of three or more chronic diseases) and disability in Daily Life Activities. The Kaplan Meier method was used to analyze survival time, and the Cox regression was used for association of the clinical factors with death. In follow-up over six years, 21.2% of the participants died, survival being lowest among those who were fragile (p < 0.05). The variables frailty (HR = 2.26; CI95%: 1.03-4.93) and Chronic Renal Insufficiency (HR = 3.00; CI95%: 1.20-7.47) were the factors of highest risk for death in the multivariate analysis. Frailty had a negative effect on the survival of these patients, but no statistically significant association was found in relation to multimorbidity or disability. Tracking of vulnerabilities in the outpatient geriatric service is important, due to the significant number of elderly people with geriatric syndromes that use this type of service, and the taking of decisions on directions for care of these individuals.