Factors predictive of outcome on admission to an acute geriatric ward

Aim: to investigate which factors predict outcome of elderly patients on di scharge and at 6 months. Methods: a prospective study in an acute geriatric ward. Within 48 h of adm ission, patients were assessed for social factors, geriatric problems, admi ssion diagnoses, medication, function and mental ability. Outcome measures were mortality, length of stay, institutionalization, readmissions and atte ndance at accident and emergency within 6 months. Results: 353 patients were studied, with a mean age of 81.8 years. Logistic regression analyses showed that variables predicting hospital mortality we re Barthel index on admission, pre-morbid disability and polypharmacy. The only variable independently predictive of prolonged stay in hospital was a Barthel score of <45 on admission. Functional disability on admission was p redictive of institutionalization on discharge. Variables predicting mortal ity within 6 months of discharge were Barthel index on admission <65, prese nce of pressure sores, malnutrition and polypharmacy. Variables independent ly predictive of institutionalization were mental state and a low pension. Those who took more than five drugs on admission were more likely to attend accident and emergency and be readmitted. Conclusion: limited activities of daily living and geriatric problems on ad mission are the strongest predictive factors of outcome, independent of dia gnoses.