Predictors of 3-month mortality in elderly patients visiting the emergency department: A retrospective cohort study

Abstract

Objective: Various studies have documented the cases of failure to thrive among elderly patients following admission to the emergency department (ED), leading to early mortality. However, studies determining the predictors of 3-month mortality in elderly patients visiting the ED in Indonesia are lacking. Materials and Methods: A retrospective cohort study was performed using secondary data of elderly patients in the ED at Dr. Cipto Mangunkusumo National Hospital between September 2016 and January 2017. We gathered 3-month mortality data using medical records and telephone interviews. Functional status decline, cognitive function impairment, polypharmacy, delirium, frailty, hypoalbuminemia, malnutrition risk, and Rapid Emergency Medicine Score were analyzed using the Chi-square test. Multivariate logistic regression analysis was performed to identify independent predictors of mortality. Results: From the 501 patients studied, 36 (7.2%) were lost to follow-up. A total of 465 patients were evaluated, with a median age of 67 years old (60–89). The overall 3-month mortality of elderly patients admitted to the ED was 32.5%. The independent predictors of 3-month mortality obtained from the multivariate analysis were functional status decline (odds ratio [OR]: 3.05; 95% confidence interval [CI]: 1.63–5.73), polypharmacy (OR: 2.65; 95% CI: 1.74–4.04), delirium (OR: 2.01; 95% CI: 1.26–3.21), and hypoalbuminemia (OR: 1.89; 95% CI: 1.02–3.50). Conclusion: Functional status decline, polypharmacy, delirium, and hypoalbuminemia are independent predictors of 3-month mortality among elderly patients in the ED.