Social support and six-month outcome among elderly patients hospitalised via emergency department: The SAFES Cohort Study.
Fiche publication
Date publication
juin 2013
Auteurs
Membres identifiés du Cancéropôle Est :
Pr JOLLY Damien
Tous les auteurs :
Drame M, Mahmoudi R, Jolly D, Rapin A, Morrone I, Boyer FC, Nazeyrollas P, Trenque T, Blanchard F, Novella JL
Lien Pubmed
Résumé
Aim: To investigate the role of social support on the risk of nursing home admission (NHA) and death at 6 months after emergency hospitalisation in persons aged 75 years and older. Methods: The study population comprised patients aged 75 years or older admitted to a short-term medical ward. Social support referred to the presence or not of informal help, instrumental support (practical help and financial help) and informational support (moral support, help with important decisions). Other data as socioeconomic and demographic data, and comorbidities were recorded as covariables. Using a multivariable Cox model, we analysed NHA and mortality within the 6 months after emergency hospitalisation. Results: After 6 months follow-up, 184 subjects out of 1047 had experienced NHA, and 319 subjects out of 1306 had died. Among these deaths, 50 (15.7%) occurred in a nursing home. By multifactorial analysis, factors significantly associated with an increased risk of NHA were: living alone (Hazard ratio, HR = 1.60; 95% confidence interval (95%CI): 1.07-2.41), and caregiver burden (HR = 2.70; 95%CI: 1.68-4.32). Conversely, the number of children was inversely related to the risk of NHA (HR = 0.85; 95%CI: 0.74-0.97). Factors found to be significantly associated with an increased risk of death were living alone (HR = 0.68; 95%CI: 0.50-0.91), age 85 years or older (HR = 1.65; 95%CI: 1.25-2.19), and level of comorbidity (HR = 1.18; 95%CI: 1.07-1.29). Conclusion: On top of clinical variables, social support seems to have an impact on the outcome of elderly persons. The results of our study plead in favour of early multidisciplinary gerontological management. (C) 2013 Elsevier Masson SAS and European Union Geriatric Medicine Society. All rights reserved.
Référence
Eur Geriatr Med. 2013 Jun;4(3):161-6.