Rate and risk factors of in-hospital and early post-discharge mortality in patients admitted to an internal medicine ward

Clin Med (Lond). 2023 Jan;23(1):16-23. doi: 10.7861/clinmed.2022-0176.

Abstract

Background: We sought to quantify in-hospital and early post-discharge mortality rates in hospitalised patients.

Methods: Consecutive adult patients admitted to an internal medicine ward were prospectively enrolled. The rates of in-hospital and 4-month post-discharge mortality and their possible associated sociodemographic and clinical factors (eg Cumulative Illness Rating Scale [CIRS], body mass index [BMI], polypharmacy, Barthel Index) were assessed.

Results: 1,451 patients (median age 80 years, IQR 69-86; 53% female) were included. Of these, 93 (6.4%) died in hospital, while 4-month post-discharge mortality was 15.9% (191/1,200). Age and high dependency were associated (p<0.01) with a higher risk of in-hospital (OR 1.04 and 2.15) and 4-month (HR 1.04 and 1.65) mortality, while malnutrition and length of stay were associated (p<0.01) with a higher risk of 4-month mortality (HR 2.13 and 1.59).

Conclusions: Several negative prognostic factors for early mortality were found. Interventions addressing dependency and malnutrition could potentially decrease early post-discharge mortality.

Keywords: Ageing; healthcare assessment; mortality predictors; multimorbidity.

MeSH terms

  • Adult
  • Aftercare
  • Aged, 80 and over
  • Female
  • Hospital Mortality
  • Hospitals
  • Humans
  • Internal Medicine
  • Length of Stay
  • Male
  • Malnutrition*
  • Patient Discharge*
  • Risk Factors