Social Vulnerability and Frailty in Hospitalized Older Adults.
Background Social vulnerability is the accumulation of disadvantageous social circumstances resulting in susceptibility to adverse health outcomes. Associated with increased mortality, cognitive decline, and disability, social vulnerability has primarily been studied in large population databases ra...
| Publicado en: | Canadian Geriatrics Journal Vol. 26; no. 3; pp. 390 - 400 |
|---|---|
| Autores principales: | , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Canadian Geriatrics Society
Sep2023
|
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=173634218&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 173634218 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 19258348 EV2Z jtl: Canadian Geriatrics Journal issn: 19258348 maglogo: N pubinfo: dt: Sep2023 vid: 26 iid: 3 pid: 76420 pub: Canadian Geriatrics Society place: Markham, Ontario artinfo: ui: 173634218 173634218 173634218 10.5770/cgj.26.638 173634218 ppf: 390 ppct: 10 formats: fmt: @attributes: type: P tig: atl: Social Vulnerability and Frailty in Hospitalized Older Adults. aug: au: Mah, Jasmine C. Godin, Judith Stevens, Susan J. Keefe, Janice M. Rockwood, Kenneth Andrew, Melissa K. affil: Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada sug: subj: Vulnerability Social Determinants of Health Frailty Syndrome In Old Age Hospitalization of Older Persons Emergency Service Health Resource Utilization Human Male Female Aged Aged, 80 and Over Tertiary Health Care Canada Canada Long Term Care Patient Discharge Odds Ratio Descriptive Statistics Clinical Assessment Tools Aged: 65+ years Aged, 80 & over Male Female ab: Background Social vulnerability is the accumulation of disadvantageous social circumstances resulting in susceptibility to adverse health outcomes. Associated with increased mortality, cognitive decline, and disability, social vulnerability has primarily been studied in large population databases rather than frail hospitalized individuals. We examined how social vulnerability contributes to hospital outcomes and use of hospital resources for older adults presenting to the Emergency Department. Methods We analyzed patients 65 years of age or older admitted through the Emergency Department and consulted to internal medicine or geriatrics at a Canadian tertiary care hospital from July 2009 to September 2020. A 20-item social vulnerability index (SVI) and a 57-item frailty index (FI) were calculated, using a deficit accumulation approach. Outcomes were length of stay (LOS), extended hospital LOS designation, alternative level of care (ALC) designation, in-hospital mortality, and discharge to long-term care (LTC). Results In 1,146 patients (mean age 80.5±8.3, 54.0% female), mean SVI was 0.40±0.16 and FI was 0.44±0.14. The SVI scores were not associated with admission to hospital. Amongst those admitted, for every 0.1 unit increase in SVI, LOS increased by 1.15 days (p<.001) after adjusting for age, sex and FI. SVI was associated with staying over the expected LOS (aOR: 1.19, 1.05-1.34, p=.009) and ALC status (aOR 1.39, 1.12-1.74, p<.004). SVI was not associated with in-hospital mortality, but was associated with incident discharge to LTC (aOR 1.03, 1.02-1.04, p<.001). Conclusion Independent of frailty, being socially vulnerable was associated with increased LOS, designation as ALC, and being discharged to LTC from hospital. Consideration of social vulnerability's influence on prolonged hospitalization and long-term care needs has implications for screening and hospital resources. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
|---|