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Open Access Research article

Three-year mortality in previously hospitalized older patients from rural areas - the importance of co-morbidity and self-reported poor health

Anne-Sofie Helvik123*, Knut Engedal456 and Geir Selbæk47

Author Affiliations

1 Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Postboks 8905, Trondheim, NO-7491, Norway

2 Innlandet Hospital Trust, Division Tynset, Tynset, Norway

3 St Olav’s University Hospital, Trondheim, Norway

4 Centre for Old Age Psychiatric Research, Innlandet Hospital Trust, Ottestad, Norway

5 The Norwegian Centre for Dementia Research, Oslo University Hospital, Ullevaal, Norway

6 Faculty of Medicine, University of Oslo, Oslo, Norway

7 Akershus University Hospital, Lørenskog, Norway

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BMC Geriatrics 2013, 13:17  doi:10.1186/1471-2318-13-17

Published: 19 February 2013

Abstract

Background

The risk factors for mortality after hospitalization in older persons are not fully understood. The aim of the present study was to examine the three-year (1,096 days) mortality in previously hospitalized older patients from rural areas, and to explore how objectively and self-reported health indicators at baseline were associated with mortality.

Methods

The study included 484 (241 men) medical inpatients with age range 65–101 (mean 80.7, SD 7.4) years. Baseline information included the following health measures: the Charlson Index, the Mini-Mental-State Examination, Lawton and Brody’s scales for physical self-maintenance and the instrumental activities of daily living, the Hospital Anxiety and Depression scale, self-reported health (one item), and perceived social functioning (one item) and assistance in living at discharge.

Results

In all, 172 (35.5%) of those patients included had died within the three years of the follow-up period. Three-year mortality was associated with a high score at baseline on the Charlson Index (HR 1.73, 95%CI 1.09-2.74) and poor self-reported health (HR 1.52, 95%CI 1.03-2.25) in a Cox regression analysis adjusted for age, gender, other objectively measured health indicators, and perceived impaired social functioning.

Conclusion

In a study of older adults admitted to a general hospital for a wide variety of disorders, we found co-morbidity (as measured with the Charlson Index) and poor self-reported health associated with three-year mortality in analysis adjusting for age, gender, and other health-related indicators. The results suggest that self-reported health is a measure that should be included in future studies.

Keywords:
Elderly; Gender; Hospitalization; Self-rated health; Survival analysis