Predicting mortality of residents at admission to nursing home: a longitudinal cohort study.

2.50
Hdl Handle:
http://hdl.handle.net/2336/225678
Title:
Predicting mortality of residents at admission to nursing home: a longitudinal cohort study.
Authors:
Hjaltadóttir, Ingibjörg; Hallberg, Ingalill Rahm; Ekwall, Anna Kristensson; Nyberg, Per
Citation:
BMC Health Serv Res 2011,11:86
Issue Date:
2011
Abstract:
BACKGROUND: An increasing numbers of deaths occur in nursing homes. Knowledge of the course of development over the years in death rates and predictors of mortality is important for officials responsible for organizing care to be able to ensure that staff is knowledgeable in the areas of care needed. The aim of this study was to investigate the time from residents' admission to Icelandic nursing homes to death and the predictive power of demographic variables, health status (health stability, pain, depression and cognitive performance) and functional profile (ADL and social engagement) for 3-year mortality in yearly cohorts from 1996-2006. METHODS: The samples consisted of residents (N = 2206) admitted to nursing homes in Iceland in 1996-2006, who were assessed once at baseline with a Minimum Data Set (MDS) within 90 days of their admittance to the nursing home. The follow-up time for survival of each cohort was 36 months from admission. Based on Kaplan-Meier analysis (log rank test) and non-parametric correlation analyses (Spearman's rho), variables associated with survival time with a p-value < 0.05 were entered into a multivariate Cox regression model. RESULTS: The median survival time was 31 months, and no significant difference was detected in the mortality rate between cohorts. Age, gender (HR 1.52), place admitted from (HR 1.27), ADL functioning (HR 1.33-1.80), health stability (HR 1.61-16.12) and ability to engage in social activities (HR 1.51-1.65) were significant predictors of mortality. A total of 28.8% of residents died within a year, 43.4% within two years and 53.1% of the residents died within 3 years. CONCLUSION: It is noteworthy that despite financial constraints, the mortality rate did not change over the study period. Health stability was a strong predictor of mortality, in addition to ADL performance. Considering these variables is thus valuable when deciding on the type of service an elderly person needs. The mortality rate showed that more than 50% died within 3 years, and almost a third of the residents may have needed palliative care within a year of admission. Considering the short survival time from admission, it seems relevant that staff is trained in providing palliative care as much as restorative care.
Description:
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Additional Links:
http://www.biomedcentral.com/1472-6963/11/86; http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3112069/?tool=pubmed
Rights:
Archived with thanks to BMC health services research

Full metadata record

DC FieldValue Language
dc.contributor.authorHjaltadóttir, Ingibjörgen_GB
dc.contributor.authorHallberg, Ingalill Rahmen_GB
dc.contributor.authorEkwall, Anna Kristenssonen_GB
dc.contributor.authorNyberg, Peren_GB
dc.date.accessioned2012-05-24T11:30:21Z-
dc.date.available2012-05-24T11:30:21Z-
dc.date.issued2011-
dc.identifier.citationBMC Health Serv Res 2011,11:86en_GB
dc.identifier.issn1472-6963-
dc.identifier.pmid21507213-
dc.identifier.doi10.1186/1472-6963-11-86-
dc.identifier.urihttp://hdl.handle.net/2336/225678-
dc.descriptionTo access publisher full text version of this article. Please click on the hyperlink in Additional Links field.en_GB
dc.description.abstractBACKGROUND: An increasing numbers of deaths occur in nursing homes. Knowledge of the course of development over the years in death rates and predictors of mortality is important for officials responsible for organizing care to be able to ensure that staff is knowledgeable in the areas of care needed. The aim of this study was to investigate the time from residents' admission to Icelandic nursing homes to death and the predictive power of demographic variables, health status (health stability, pain, depression and cognitive performance) and functional profile (ADL and social engagement) for 3-year mortality in yearly cohorts from 1996-2006. METHODS: The samples consisted of residents (N = 2206) admitted to nursing homes in Iceland in 1996-2006, who were assessed once at baseline with a Minimum Data Set (MDS) within 90 days of their admittance to the nursing home. The follow-up time for survival of each cohort was 36 months from admission. Based on Kaplan-Meier analysis (log rank test) and non-parametric correlation analyses (Spearman's rho), variables associated with survival time with a p-value < 0.05 were entered into a multivariate Cox regression model. RESULTS: The median survival time was 31 months, and no significant difference was detected in the mortality rate between cohorts. Age, gender (HR 1.52), place admitted from (HR 1.27), ADL functioning (HR 1.33-1.80), health stability (HR 1.61-16.12) and ability to engage in social activities (HR 1.51-1.65) were significant predictors of mortality. A total of 28.8% of residents died within a year, 43.4% within two years and 53.1% of the residents died within 3 years. CONCLUSION: It is noteworthy that despite financial constraints, the mortality rate did not change over the study period. Health stability was a strong predictor of mortality, in addition to ADL performance. Considering these variables is thus valuable when deciding on the type of service an elderly person needs. The mortality rate showed that more than 50% died within 3 years, and almost a third of the residents may have needed palliative care within a year of admission. Considering the short survival time from admission, it seems relevant that staff is trained in providing palliative care as much as restorative care.en_GB
dc.description.sponsorshipDepartment of Health Sciences at Lund University, Sweden National University Hospital of Iceland Icelandic Nurses Association Icelandic Geriatric Councilen_GB
dc.language.isoenen
dc.publisherBioMed Centralen_GB
dc.relation.urlhttp://www.biomedcentral.com/1472-6963/11/86en_GB
dc.relation.urlhttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC3112069/?tool=pubmeden_GB
dc.rightsArchived with thanks to BMC health services researchen_GB
dc.subject.meshActivities of Daily Livingen_GB
dc.subject.meshAged, 80 and overen_GB
dc.subject.meshCohort Studiesen_GB
dc.subject.meshFemaleen_GB
dc.subject.meshHealth Knowledge, Attitudes, Practiceen_GB
dc.subject.meshHealth Servicesen_GB
dc.subject.meshHealth Status Indicatorsen_GB
dc.subject.meshHospitalizationen_GB
dc.subject.meshHumansen_GB
dc.subject.meshIcelanden_GB
dc.subject.meshInterview, Psychologicalen_GB
dc.subject.meshKaplan-Meier Estimateen_GB
dc.subject.meshLongitudinal Studiesen_GB
dc.subject.meshMaleen_GB
dc.subject.meshMortalityen_GB
dc.subject.meshNursing Homesen_GB
dc.subject.meshProfessional Competenceen_GB
dc.subject.meshStatistics as Topicen_GB
dc.subject.meshTime Factorsen_GB
dc.titlePredicting mortality of residents at admission to nursing home: a longitudinal cohort study.en
dc.typeArticleen
dc.contributor.departmentDepartment of Health Sciences, Lund University, Lund, Sweden. ingihj@landspitali.isen_GB
dc.identifier.journalBMC health services researchen_GB
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