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The prognostic significance of geriatric syndromes and resources

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Abstract

Background

Geriatric syndromes (GS) do not fit into discrete disease categories and are often underdiagnosed in hospitalized older adults. Geriatric resources (GR) are also not routinely collected in clinical settings, although this may potentiate the beneficial effects of clinical decisions. The prognostic relevance of GS and GR has never been systematically evaluated through clinical tools developed for clinical decision purposes.

Aim

To ascertain the impact of common GS and GR on patients’ prognosis as assessed by means of the comprehensive geriatric assessment (CGA)-based Multidimensional Prognostic Index (MPI).

Methods

One hundred and thirty-five hospitalized patients aged 70 years and older underwent a CGA evaluation with calculation of the MPI on admission and discharge. Accordingly, patients were subdivided in low (MPI-1, score 0–0.33), moderate (MPI-2, score 0.34–0.66), and severe (MPI-3, score 0.67–1)-risk of mortality at 1 month and 1 year. Nine GR and 17 GS were identified and collected accordingly.

Results

A lower number of GS and a higher number of GR were shown to be highly significantly correlated with a lower MPI, as well as years of education, grade of care, and number of medications independent of age, sex and number of GS or GR. Underweight and obesity according to the BMI were significantly correlated to higher number of GS. Patients with more GR had a significantly higher chance of being discharged home.

Conclusions

The MPI evaluation together with GS and GR in acute care for older patients should be encouraged to improve clinical decision-making.

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Acknowledgements

The results were partly presented at the 2018 annual conference of the German Internal Medicine Society as well as at the 2017 annual conference of the German Geriatrics Society, where the work received the Advancement Award for Interdisciplinary Aging Research of the German Geriatrics Society. The authors are grateful to the patients who took their time during the hospital stay to take part into the study.

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Author notes

  1. Alberto Pilotto and M. Cristina Polidori are equal supervisors.

Authors and Affiliations

  1. Department II of Internal Medicine and Center for Molecular Medicine Cologne, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany

    Anna Maria Meyer, Paul Thomas Brinkkötter, Thomas Benzing & M. Cristina Polidori

  2. Institute of Medical Statistics and Computational Biology, University Hospital of Cologne, Cologne, Germany

    Ingrid Becker

  3. Scientific Directorate - Biostatistics, E.O. Galliera Hospital, Genova, Italy

    Giacomo Siri

  4. CECAD, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany

    Paul Thomas Brinkkötter & Thomas Benzing

  5. Department Geriatric Care, Orthogeriatrics and Rehabilitation, Frailty Area, E.O. Galliera Hospital, Genova, Italy

    Alberto Pilotto

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  1. Anna Maria Meyer
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  2. Ingrid Becker
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  3. Giacomo Siri
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  7. M. Cristina Polidori
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Contributions

Conceived and designed the clinical trial: AMM MCP. Performed the experiments: AMM. Analysed the data: AMM IB GS. Wrote the paper: AMM. Conception of the manuscript: AMM MCP. Critical revisions: AMM IB PTB TB AP MCP.

Corresponding author

Correspondence to M. Cristina Polidori.

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Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the Ethical Committee of the University Hospital of Cologne, Germany (the study is registered at the German Clinical Trials Register: DRKS00010606) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Each patient or proxy respondent signed informed consent.

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Meyer, A.M., Becker, I., Siri, G. et al. The prognostic significance of geriatric syndromes and resources. Aging Clin Exp Res 32, 115–124 (2020). https://doi.org/10.1007/s40520-019-01168-9

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