Factors influencing length of hospital stay in an acute psychogeriatric unit.

BACKGROUND: Dementia patients represent a significant volume of hospital admissions and impose a high cost on the health system. There is a significantly higher length of hospital stay (LOHS) for elderly demented patients. METHODS: This study was carried out in an acute psychogeriatric unit specialising in behavioural and psychological symptoms in dementia. Socio-demographic, cognitive and nutritional variables were taken into account. We first compared the patients returning home (group 1) after hospital discharge with those transferred to the rehabilitation psychogeriatric unit (group 2). We secondarily explored the correlation of LOHS with the variables described above for the two groups. RESULTS: We retained 92 patients (of 375 admitted) for our study, mean age 83.9 ± 6.6, Mini-Mental State Examination 12.8 ± 9.6, initial weight 61.7 ± 13.2 kg and body mass index 24.8 ± 4.7. We noticed significant differences in cognitive status but not in nutritional variables or in socio-demographic characteristics between the two groups. Only weight in nutritional variables was significantly associated with LOHS in the acute psychogeriatric unit. CONCLUSIONS: Our main finding underlined the key role of cognitive factors in patient discharge home. And only initial weigh seems have an influence in LOHS instead of cognitive status or socio-demographic characteristics.

Clinical Characteristics and Outcomes of 821 Older Patients With SARS-Cov-2 Infection Admitted to Acute Care Geriatric Wards.

BACKGROUND: There is limited information describing the characteristics and outcomes of hospitalized older patients with confirmed coronavirus disease 2019 (COVID-19). METHOD: We conducted a multicentric retrospective cohort study in 13 acute COVID-19 geriatric wards, from March 13 to April 15, 2020, in Paris area. All consecutive patients aged 70 years and older, with confirmed COVID-19, were enrolled. RESULTS: Of the 821 patients included in the study, the mean (SD) age was 86 (7) years; 58% were female; 85% had ≥2 comorbidities; 29% lived in an institution; and the median [interquartile range] Activities of Daily Living scale (ADL) score was 4 [2-6]. The most common symptoms at COVID-19 onset were asthenia (63%), fever (55%), dyspnea (45%), dry cough (45%), and delirium (25%). The in-hospital mortality was 31% (95% confidence interval [CI] 27-33). On multivariate analysis, at COVID-19 onset, the probability of in-hospital mortality was increased with male gender (odds ratio [OR] 1.85; 95% CI 1.30-2.63), ADL score <4 (OR 1.84; 95% CI 1.25-2.70), asthenia (OR 1.59; 95% CI 1.08-2.32), quick Sequential Organ Failure Assessment score ≥2 (OR 2.63; 95% CI 1.64-4.22), and specific COVID-19 anomalies on chest computerized tomography (OR 2.60; 95% CI 1.07-6.46). CONCLUSIONS: This study provides new information about older patients with COVID-19 who are hospitalized. A quick bedside evaluation at admission of sex, functional status, systolic arterial pressure, consciousness, respiratory rate, and asthenia can identify older patients at risk of unfavorable outcomes.