Universität zu Köln

Veronese, Nicola, Siri, Giacomo ORCID: 0000-0001-8006-0668, Cella, Alberto, Daragjati, Julia, Cruz-Jentoft, Alfonso J., Polidori, Maria Cristina, Mattace-Raso, Francesco, Paccalin, Marc, Topinkova, Eva, Greco, Antonio, Mangoni, Arduino A., Maggi, Stefania, Ferrucci, Luigi and Pilotto, Alberto (2019). Older women are frailer, but less often die then men: a prospective study of older hospitalized people. Maturitas, 128. S. 81 - 87. CLARE: ELSEVIER IRELAND LTD. ISSN 1873-4111

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Abstract

Objectives: The association between frailty, mortality and sex is complex, but a limited literature is available on this topic, particularly for older hospitalized patients. Therefore, the objective of our study was to prospectively evaluate sex differences in frailty, assessed by the Multidimensional Prognostic Index (MPI) and mortality, institutionalization, and re-hospitalization in an international cohort of older people admitted to hospital. Study design: We used data from nine public hospitals in Europe and Australia, to evaluate sex differences in mortality, frailty and the risk of institutionalization and re-hospitalization, during one year of follow-up. Main outcome measures: People aged 65 years or more admitted to hospital for an acute medical condition or for a relapse of a chronic disease were included. A standardized comprehensive geriatric assessment, which evaluated functional, nutritional, and cognitive status, risk of pressure sores, comorbidities, medications and cohabitation status, was used to calculate the MPI to measure frailty in all hospitalized older people. Data regarding mortality, institutionalization and re-hospitalization were also recorded for one year. Results: Altogether, 1140 hospitalized patients (mean age = 84.2 years; 694 women = 60.9%) were included. The one-year mortality rate was 33.2%. In multivariate analysis, adjusted for age, MPI score, centre and diagnosis at baseline, although women had higher MPI scores than men, the latter had higher in-hospital (odds ratio, OR = 2.26; 95% confidence intervals, CI = 1.27-4.01) and one-year post-discharge mortality (OR = 2.04; 95%CI = 1.50-2.79). Furthermore, men were less frequently institutionalized in a care home than female patients (OR = 0.55; 95%CI: 0.34-0.91), but they were also more frequently re-hospitalized (OR = 1.42; 95%CI: 1.06-1.91) during the year after hospital discharge. Conclusion: Older hospitalized men were less frail, but experienced higher in-hospital and one-year mortality than women. Women were admitted more frequently to nursing homes and experienced a lower risk of rehospitalization. These findings suggest important differences between the sexes and extends the 'male-female health-survival paradox' to acutely ill patient groups.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Veronese, Nicola UNSPECIFIED UNSPECIFIED UNSPECIFIED Siri, Giacomo UNSPECIFIED orcid.org/0000-0001-8006-0668 UNSPECIFIED Cella, Alberto UNSPECIFIED UNSPECIFIED UNSPECIFIED Daragjati, Julia UNSPECIFIED UNSPECIFIED UNSPECIFIED Cruz-Jentoft, Alfonso J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Polidori, Maria Cristina UNSPECIFIED UNSPECIFIED UNSPECIFIED Mattace-Raso, Francesco UNSPECIFIED UNSPECIFIED UNSPECIFIED Paccalin, Marc UNSPECIFIED UNSPECIFIED UNSPECIFIED Topinkova, Eva UNSPECIFIED UNSPECIFIED UNSPECIFIED Greco, Antonio UNSPECIFIED UNSPECIFIED UNSPECIFIED Mangoni, Arduino A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Maggi, Stefania UNSPECIFIED UNSPECIFIED UNSPECIFIED Ferrucci, Luigi UNSPECIFIED UNSPECIFIED UNSPECIFIED Pilotto, Alberto UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-132912
DOI:	10.1016/j.maturitas.2019.07.025
Journal or Publication Title:	Maturitas
Volume:	128
Page Range:	S. 81 - 87
Date:	2019
Publisher:	ELSEVIER IRELAND LTD
Place of Publication:	CLARE
ISSN:	1873-4111
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language MULTIDIMENSIONAL PROGNOSTIC INDEX; ONE-YEAR MORTALITY; SEX-DIFFERENCES; HEALTH; CARE; PREVALENCE; VALIDATION Multiple languages Geriatrics & Gerontology; Obstetrics & Gynecology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/13291