Abstract
A multicenter observational study, REPOSI (REgistro POliterapie Società Italiana di Medicina Interna), was conducted to assess the prognostic value of glomerular filtration rate (eGFR) on in-hospital mortality, hospital re-admission and death within 3 months, in a sample of elderly patients (n = 1,363) admitted to 66 internal medicine and geriatric wards. Based on eGFR, calculated by the new Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formula, subjects at hospital admission were classified into three groups: group 1 with normal eGFR (≥60 ml/min/1.73 m2, reference group), group 2 with moderately reduced eGFR (30–59 ml/min/1.73 m2) and group 3 with severely reduced eGFR (2). Patients with the lowest eGFR (group 3) on admission were more likely to be older, to have a greater cognitive and functional impairment and a high rate of comorbidities. Multivariable logistic regression analysis showed that severely reduced eGFR at the time of admission was associated with in-hospital mortality (OR 3.00; 95 % CI 1.20–7.39, p = 0.0230), but not with re-hospitalization (OR 0.97; 95 % CI 0.54–1.76, p = 0.9156) or mortality at 3 months after discharge (OR 1.93; 95 % CI 0.92–4.04, p = 0.1582). On the contrary, an increased risk (OR 2.60; 95 % CI 1.13–5.98, p = 0.0813) to die within 3 months after discharge was associated with decreased eGFR measured at the time of discharge. Our study demonstrates that severely reduced eGFRs in elderly patients admitted to hospital are strong predictors of the risk of dying during hospitalization, and that this measurement at the time of discharge helps to predict early death after hospitalization.
| Original language | English |
|---|---|
| Pages (from-to) | 735-747 |
| Number of pages | 13 |
| Journal | Internal and Emergency Medicine |
| Volume | 9 |
| Issue number | 7 |
| DOIs | |
| Publication status | Published - Oct 2 2014 |
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Keywords
- Comorbidity
- eGFR
- In-hospital elderly patients
- Multicenter study
- Polypharmacy
ASJC Scopus subject areas
- Emergency Medicine
- Internal Medicine
Cite this
Prognostic value of estimated glomerular filtration rate in hospitalized elderly patients. / De La Higuera, Laura; Riva, Emma; Djade, Codjo Djignefa; Mandelli, Sara; Franchi, Carlotta; Marengoni, Alessandra; Salerno, Francesco; Corrao, Salvatore; Pasina, Luca; Tettamanti, Mauro; Marcucci, Maura; Mannucci, Pier Mannuccio; Nobili, Alessandro.
In: Internal and Emergency Medicine, Vol. 9, No. 7, 02.10.2014, p. 735-747.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Prognostic value of estimated glomerular filtration rate in hospitalized elderly patients
AU - De La Higuera, Laura
AU - Riva, Emma
AU - Djade, Codjo Djignefa
AU - Mandelli, Sara
AU - Franchi, Carlotta
AU - Marengoni, Alessandra
AU - Salerno, Francesco
AU - Corrao, Salvatore
AU - Pasina, Luca
AU - Tettamanti, Mauro
AU - Marcucci, Maura
AU - Mannucci, Pier Mannuccio
AU - Nobili, Alessandro
PY - 2014/10/2
Y1 - 2014/10/2
N2 - A multicenter observational study, REPOSI (REgistro POliterapie Società Italiana di Medicina Interna), was conducted to assess the prognostic value of glomerular filtration rate (eGFR) on in-hospital mortality, hospital re-admission and death within 3 months, in a sample of elderly patients (n = 1,363) admitted to 66 internal medicine and geriatric wards. Based on eGFR, calculated by the new Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formula, subjects at hospital admission were classified into three groups: group 1 with normal eGFR (≥60 ml/min/1.73 m2, reference group), group 2 with moderately reduced eGFR (30–59 ml/min/1.73 m2) and group 3 with severely reduced eGFR (2). Patients with the lowest eGFR (group 3) on admission were more likely to be older, to have a greater cognitive and functional impairment and a high rate of comorbidities. Multivariable logistic regression analysis showed that severely reduced eGFR at the time of admission was associated with in-hospital mortality (OR 3.00; 95 % CI 1.20–7.39, p = 0.0230), but not with re-hospitalization (OR 0.97; 95 % CI 0.54–1.76, p = 0.9156) or mortality at 3 months after discharge (OR 1.93; 95 % CI 0.92–4.04, p = 0.1582). On the contrary, an increased risk (OR 2.60; 95 % CI 1.13–5.98, p = 0.0813) to die within 3 months after discharge was associated with decreased eGFR measured at the time of discharge. Our study demonstrates that severely reduced eGFRs in elderly patients admitted to hospital are strong predictors of the risk of dying during hospitalization, and that this measurement at the time of discharge helps to predict early death after hospitalization.
AB - A multicenter observational study, REPOSI (REgistro POliterapie Società Italiana di Medicina Interna), was conducted to assess the prognostic value of glomerular filtration rate (eGFR) on in-hospital mortality, hospital re-admission and death within 3 months, in a sample of elderly patients (n = 1,363) admitted to 66 internal medicine and geriatric wards. Based on eGFR, calculated by the new Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formula, subjects at hospital admission were classified into three groups: group 1 with normal eGFR (≥60 ml/min/1.73 m2, reference group), group 2 with moderately reduced eGFR (30–59 ml/min/1.73 m2) and group 3 with severely reduced eGFR (2). Patients with the lowest eGFR (group 3) on admission were more likely to be older, to have a greater cognitive and functional impairment and a high rate of comorbidities. Multivariable logistic regression analysis showed that severely reduced eGFR at the time of admission was associated with in-hospital mortality (OR 3.00; 95 % CI 1.20–7.39, p = 0.0230), but not with re-hospitalization (OR 0.97; 95 % CI 0.54–1.76, p = 0.9156) or mortality at 3 months after discharge (OR 1.93; 95 % CI 0.92–4.04, p = 0.1582). On the contrary, an increased risk (OR 2.60; 95 % CI 1.13–5.98, p = 0.0813) to die within 3 months after discharge was associated with decreased eGFR measured at the time of discharge. Our study demonstrates that severely reduced eGFRs in elderly patients admitted to hospital are strong predictors of the risk of dying during hospitalization, and that this measurement at the time of discharge helps to predict early death after hospitalization.
KW - Comorbidity
KW - eGFR
KW - In-hospital elderly patients
KW - Multicenter study
KW - Polypharmacy
UR - http://www.scopus.com/inward/record.url?scp=84918842140&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84918842140&partnerID=8YFLogxK
U2 - 10.1007/s11739-013-1028-5
DO - 10.1007/s11739-013-1028-5
M3 - Article
C2 - 24338497
AN - SCOPUS:84918842140
VL - 9
SP - 735
EP - 747
JO - Internal and Emergency Medicine
JF - Internal and Emergency Medicine
SN - 1828-0447
IS - 7
ER -