Relationship between Social Demographic Factors and Survival within One Year of Hospital Discharge in a Cohort of Elderly Male Patients

Longjian Liu · Dennis H. Sullivan

14 citations0/0 files storedJournal of Epidemiology

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Health disparities and outcomes Aging, Health, and Disability Frailty in Older Adults

Abstract

BACKGROUND: Little is known about the impact of social demographic factors on post-discharge mortality among the hospitalized elderly. METHODS: A one-year prospective study was conducted in a random sample of 646 male patients aged 65 or older who were discharged from a university affiliated Veterans Administration Hospital at Little Rock, AR, USA. Within 48 hours of admission, each subject completed a standardized diagnostic evaluation. Mortality was recorded for all causes. Associations between patient characteristics at hospital discharge and mortality were identified utilizing univariable and multivariable (Cox proportional hazard regression) statistical techniques. RESULTS: The mean (SD) age was 73(+/- 6) years. Within one year of hospital discharge, 83 patients (13%) died. Multiple social demographic factors were significantly associated with mortality in univariable analysis. After controlling for age, Katz index of ADL score, Charlson co-morbidity index and length of hospitalization, risk of one-year post-discharge mortality remained significantly associated with marital status, race, education, and occupational class. When all of the social demographic factors were included in a stepwise procedure, marital status, education and occupational class were selected as the strongest predictors of mortality. The adjusted hazard ratios (95% confidence interval) of mortality associated with non-married status, education < 6 years, and history of having a blue-collar occupation were 2.01 (1.29-3.15), 1.86 (1.05-3.32), and 2.16 (1.03-4.54) respectively. CONCLUSION: The results suggest that social demographic factors are independent determinants of mortality among elderly patients. These factors should be used as important indices in identifying patients at higher risk of death in clinical assessments and in prevention programs for elderly patients after hospital discharge.

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References

1980Survey Methods in Community Medicine 2002Living Arrangements of Older Adults in the Developing World: An Analysis of Demographic and Health Survey Household Surveys 2001Income differences in mortality: a register-based follow-up study of three million men and women 1995Marital Status, Change in Marital Status, and Mortality in Middle-aged British Men 1995Impact of marital status on outcomes in hospitalized patients. Evidence from an academic medical center 2000Marital status and mortality in British women: a longitudinal study 1997Socioeconomic status within social class and mortality: a prospective study in middle-aged British men 2002Socioeconomic inequalities in all-cause and specific-cause mortality in Australia: 1985–1987 and 1995–1997

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