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Time trends in hospital discharges in patients aged 85 years and older in Spain: data from the Spanish National Discharge Database (2000–2015)
BACKGROUND: The aging population is an increasing concern in Western hospital systems. The aim of this study was to describe the main characteristics and hospitalization patterns in inpatients aged 85 years or more in Spain from 2000 to 2015. METHODS: Retrospective observational study analyzing data...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8207637/ https://www.ncbi.nlm.nih.gov/pubmed/34134638 http://dx.doi.org/10.1186/s12877-021-02335-2 |
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author | Palacios-Fernandez, Sergio Salcedo, Mario Gonzalez-Alcaide, Gregorio Ramos-Rincon, Jose-Manuel |
author_facet | Palacios-Fernandez, Sergio Salcedo, Mario Gonzalez-Alcaide, Gregorio Ramos-Rincon, Jose-Manuel |
author_sort | Palacios-Fernandez, Sergio |
collection | PubMed |
description | BACKGROUND: The aging population is an increasing concern in Western hospital systems. The aim of this study was to describe the main characteristics and hospitalization patterns in inpatients aged 85 years or more in Spain from 2000 to 2015. METHODS: Retrospective observational study analyzing data from the minimum basic data set, an administrative registry recording each hospital discharge in Spain since 1997. We collected administrative, economic and clinical data for all discharges between 2000 and 2015 in patients aged 85 years and older, reporting results in three age groups and four time periods to assess differences and compare trends. RESULTS: There were 4,387,326 discharges in very elderly patients in Spain from 2000 to 2015, representing 5.32% of total discharges in 2000–2003 and 10.42% in 2012–2015. The pace of growth was faster in older age groups, with an annual percentage increase of 6% in patients aged 85–89 years, 7.79% in those aged 90–94 years, and 8.06% in those aged 95 and older. The proportion of men also rose (37.30 to 39.70%, p < 0.001). The proportion of patients that died during hospital admission decreased from 14.64% in 2000–2003 to 13.83% in 2012–2015 (p < 0.001), and mean length of stay from 9.98 days in 2000–2003 to 8.34 days in 2012–2015. Some of the most frequent primary diagnoses became even more frequent relative to the total number of primary diagnoses, such as heart failure (7.84 to 10.62%), pneumonia (6.36 to 7.36%), other respiratory diseases (3.87 to 8.49%) or other alterations of urinary tract (3.08 to 5.20%). However, there was a relative decrease in the proportion of femoral neck fractures (8.07 to 6.77%), neoplasms (7.65 to 7.34%), ischemic encephalopathy (6.97 to 5.85%), COPD (4.23 to 3.15%), ischemic cardiomyopathy (4.20 to 8.49%) and cholelithiasis (3.07 to 3.28%). CONCLUSIONS: Discharges in the very elderly population are increasing in both relative and absolute terms in Spanish hospitals. Within this group, discharged patients are getting older and more frequently male. The mean length of stay and the proportion of patients that died during hospital admission are decreasing. Acute-on-chronic organ diseases, neoplasms, acute cardiovascular diseases, and infections are the most common causes of discharge. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12877-021-02335-2. |
format | Online Article Text |
id | pubmed-8207637 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-82076372021-06-16 Time trends in hospital discharges in patients aged 85 years and older in Spain: data from the Spanish National Discharge Database (2000–2015) Palacios-Fernandez, Sergio Salcedo, Mario Gonzalez-Alcaide, Gregorio Ramos-Rincon, Jose-Manuel BMC Geriatr Research Article BACKGROUND: The aging population is an increasing concern in Western hospital systems. The aim of this study was to describe the main characteristics and hospitalization patterns in inpatients aged 85 years or more in Spain from 2000 to 2015. METHODS: Retrospective observational study analyzing data from the minimum basic data set, an administrative registry recording each hospital discharge in Spain since 1997. We collected administrative, economic and clinical data for all discharges between 2000 and 2015 in patients aged 85 years and older, reporting results in three age groups and four time periods to assess differences and compare trends. RESULTS: There were 4,387,326 discharges in very elderly patients in Spain from 2000 to 2015, representing 5.32% of total discharges in 2000–2003 and 10.42% in 2012–2015. The pace of growth was faster in older age groups, with an annual percentage increase of 6% in patients aged 85–89 years, 7.79% in those aged 90–94 years, and 8.06% in those aged 95 and older. The proportion of men also rose (37.30 to 39.70%, p < 0.001). The proportion of patients that died during hospital admission decreased from 14.64% in 2000–2003 to 13.83% in 2012–2015 (p < 0.001), and mean length of stay from 9.98 days in 2000–2003 to 8.34 days in 2012–2015. Some of the most frequent primary diagnoses became even more frequent relative to the total number of primary diagnoses, such as heart failure (7.84 to 10.62%), pneumonia (6.36 to 7.36%), other respiratory diseases (3.87 to 8.49%) or other alterations of urinary tract (3.08 to 5.20%). However, there was a relative decrease in the proportion of femoral neck fractures (8.07 to 6.77%), neoplasms (7.65 to 7.34%), ischemic encephalopathy (6.97 to 5.85%), COPD (4.23 to 3.15%), ischemic cardiomyopathy (4.20 to 8.49%) and cholelithiasis (3.07 to 3.28%). CONCLUSIONS: Discharges in the very elderly population are increasing in both relative and absolute terms in Spanish hospitals. Within this group, discharged patients are getting older and more frequently male. The mean length of stay and the proportion of patients that died during hospital admission are decreasing. Acute-on-chronic organ diseases, neoplasms, acute cardiovascular diseases, and infections are the most common causes of discharge. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12877-021-02335-2. BioMed Central 2021-06-16 /pmc/articles/PMC8207637/ /pubmed/34134638 http://dx.doi.org/10.1186/s12877-021-02335-2 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Article Palacios-Fernandez, Sergio Salcedo, Mario Gonzalez-Alcaide, Gregorio Ramos-Rincon, Jose-Manuel Time trends in hospital discharges in patients aged 85 years and older in Spain: data from the Spanish National Discharge Database (2000–2015) |
title | Time trends in hospital discharges in patients aged 85 years and older in Spain: data from the Spanish National Discharge Database (2000–2015) |
title_full | Time trends in hospital discharges in patients aged 85 years and older in Spain: data from the Spanish National Discharge Database (2000–2015) |
title_fullStr | Time trends in hospital discharges in patients aged 85 years and older in Spain: data from the Spanish National Discharge Database (2000–2015) |
title_full_unstemmed | Time trends in hospital discharges in patients aged 85 years and older in Spain: data from the Spanish National Discharge Database (2000–2015) |
title_short | Time trends in hospital discharges in patients aged 85 years and older in Spain: data from the Spanish National Discharge Database (2000–2015) |
title_sort | time trends in hospital discharges in patients aged 85 years and older in spain: data from the spanish national discharge database (2000–2015) |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8207637/ https://www.ncbi.nlm.nih.gov/pubmed/34134638 http://dx.doi.org/10.1186/s12877-021-02335-2 |
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