The effect of COPD on length of stay and in-hospital mortality of diabetic patients

Abstract Background Chronic Obstructive Pulmonary Disease (COPD) is a preventable and treatable disease characterized by persistent respiratory symptoms and airflow limitation. It is currently one of the leading cause of death worldwide. Metabolic syndrome has been recognized as one of the most relevant clinical comorbidities associated with COPD. Diabetes is more prevalent in COPD than in the general population, ranging between 10.1-23.0%. However, the link between COPD and diabetes is much less clear. The aim of this study was to investigate the effect of COPD on diabetic patients, focusing on length of stay and in-hospital mortality. Methods The study considered all hospital admissions of diabetic patients aged over 65 years performed between January 2006 and December 2015 in Abruzzo, a region of Italy. Data were collected from all hospital discharge records. A 1:1 propensity score-matching algorithm was used to match patients with and without COPD, according to their baseline characteristics. Logistic regression analysis was performed to evaluate the risk of in-hospital mortality and prolonged length of stay among diabetic patients with COPD. Results A total of 140,556 ?patients were included: 18,379 with COPD and 122,177 without COPD. After matching procedure, 36,758 patients were included into the analysis: 18,379 with COPD and 18,379 controls. After matching, all the baseline characteristics resulted well balanced, with a standardized mean difference less than 10% for all the variables considered. COPD patients showed a higher risk of in-hospital mortality (OR: 1.10; 95%CI 1.01-1.20; p = 0.036) and length of stay over 15 days (OR:1.18; 95%CI 1.06-1.31; p = 0.002). Conclusions In a cohort of Italian patients, diabetic patients with COPD showed a higher risk of in-hospital mortality and prolonged length of stay compared with diabetic patients without COPD. Defining the causes of these differences would improve public health surveillance systems and policies. Key messages Diabetes is more prevalent in COPD than in the general population. Diabetic patients with COPD showed a higher risk of in-hospital mortality and prolonged length of stay compared with diabetic patients without COPD.

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Validity of the diagnosis of pneumonia in hospitalised patients with COPD

ERJ Open Research ◽

10.1183/23120541.00031-2019 ◽

2019 ◽

Vol 5 (2) ◽

pp. 00031-2019 ◽

Cited By ~ 6

Author(s):

Lydia J. Finney ◽

Vijay Padmanaban ◽

Samuel Todd ◽

Nadia Ahmed ◽

Sarah L. Elkin ◽

...

Keyword(s):

Length Of Stay ◽

Chest Radiograph ◽

Hospital Admissions ◽

Inhaled Corticosteroids ◽

Chronic Obstructive ◽

Discharge Diagnosis ◽

Prolonged Length ◽

High Dependency ◽

Copd Patients ◽

Hospitalised Patients

RationaleExacerbations of chronic obstructive pulmonary disease (COPD) and pneumonia are two of the most common reasons for acute hospital admissions. Acute exacerbations and pneumonia present with similar symptoms in COPD patients, representing a diagnostic challenge with a significant impact on patient outcomes. The objectives of this study were to compare the prevalence of radiographic consolidation with the discharge diagnoses of hospitalised COPD patients.MethodsCOPD patients admitted to three UK hospitals over a 3-year period were identified. Participants were included if they were admitted with an acute respiratory illness, COPD was confirmed by spirometry and a chest radiograph was performed within 24 h of admission. Pneumonia was defined as consolidation on chest radiograph reviewed by two independent observersResultsThere were 941 admissions in 621 patients included in the final analysis. In 235 admissions, consolidation was present on chest radiography and there were 706 admissions without consolidation. Of the 235 admissions with consolidation, only 42.9% had a discharge diagnosis of pneumonia; 90.7% of patients without consolidation had a discharge diagnosis of COPD exacerbation. The presence of consolidation was associated with increased rate of high-dependency care admission, increased mortality and prolonged length of stay. Inhaled corticosteroid use was associated with recurrent pneumonia.ConclusionsPneumonia is underdiagnosed in patients with COPD. Radiographic consolidation is associated with worse outcomes and prolonged length of stay. Incorrect diagnosis could result in inappropriate use of inhaled corticosteroids. Future guidelines should specifically address the diagnosis and management of pneumonia in COPD.

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Retrospective Study on Hospital Admissions due to Pyelonephritis in Type II Diabetic Patients

Journal of Medical - Clinical Research & Reviews ◽

10.33425/2639-944x.1220 ◽

2021 ◽

Vol 5 (6) ◽

Author(s):

Dilraj Dhillon ◽

Thomas Randall ◽

David Zezoff ◽

Mouchumi Bhattacharyya

Keyword(s):

Retrospective Study ◽

Length Of Stay ◽

Hospital Admissions ◽

Type Ii Diabetes Mellitus ◽

Hospitalized Patients ◽

Diabetic Patients ◽

Clean Intermittent Catheterization ◽

Type Ii ◽

Indwelling Catheters ◽

Significant Difference

Background: Pyelonephritis is a urinary tract infection that ascends to involve the kidneys. It can also occur as an infection secondary to bacteremia. Some pathogens that commonly cause pyelonephritis are E. coli, enterobacteriaceae, staphylococci, and pseudomonas. The initial patient presentation usually involves fever, chills, nausea, vomiting, costovertebral angle tenderness, and flank pain. Other cystitis symptoms such as dysuria, increased urinary frequency, malodorous urine, and hematuria may or may not be present. Symptoms of pyelonephritis with bacteriuria are sufficient for the diagnosis of pyelonephritis. Aim: The aim of this study was to investigate a potential link between Type II Diabetes Mellitus and pyelonephritis. Methods: In this retrospective study, hospitalized patients during the study period were reviewed. Variables examined were sex, age, and length of stay. Patients were excluded if they had known urogenital abnormalities, indwelling catheters (Foley, nephrostomy, suprapubic, or who regularly perform clean intermittent catheterization), were pregnant, or were on dialysis. Results: Of 333 patients analyzed, diabetics had a longer length of stay then non-diabetics (4.49 vs 3.67 days respectively; p=0.0041) and females were significantly younger than men in hospitalized patients for pyelonephritis were (50.0 vs 63.5 years; p=<0.0001). Further, it was found that diabetics were significantly older than nondiabetics were (60.4 vs 47.3; p=<0.0001) and more diabetics getting admitted with pyelonephritis were men vs women (59.32% vs 35.27%; p=0.0007). Conclusion: Results of the study were significant in showing that of all pyelonephritis-hospitalized patients on average the length of stay was longer for diabetics and it demonstrated that female patients with pyelonephritis are significantly younger than male patients hospitalized with pyelonephritis. Of note, there was no significant difference in the length of stay for diabetic patients based on their treatment modality (diet controlled vs. oral medications vs. insulin dependent vs. combined). The study also showed that diabetics getting admitted for pyelonephritis are more men and older in age compared to the nondiabetics.

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COVID-19 health inequities and association with mechanical ventilation and prolonged length of stay at an urban safety-net health system in Chicago

PLoS ONE ◽

10.1371/journal.pone.0258243 ◽

2021 ◽

Vol 16 (10) ◽

pp. e0258243

Author(s):

Jacquelyn Jacobs ◽

Amy K. Johnson ◽

Arianna Boshara ◽

Bijou Hunt ◽

Christina Khouri ◽

...

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Mechanical Ventilation ◽

Length Of Stay ◽

Pulmonary Disease ◽

Safety Net ◽

Chronic Obstructive ◽

Minority Population ◽

Obstructive Pulmonary Disease ◽

Ethnic Minority Population ◽

Prolonged Length

Millions of Americans have been infected with COVID-19 and communities of color have been disproportionately burdened. We investigated the relationship between demographic characteristics and COVID-19 positivity, and comorbidities and severe COVID-19 illness (use of mechanical ventilation and length of stay) within a racial/ethnic minority population. Patients tested for COVID-19 between March 2020 and January 2021 (N = 14171) were 49.9% (n = 7072) female; 50.1% (n = 7104) non-Hispanic Black; 33.2% (n = 4698) Hispanic; and 23.6% (n = 3348) aged 65+. Overall COVID-19 positivity was 16.1% (n = 2286). Compared to females, males were 1.1 times more likely to test positive (p = 0.014). Compared to non-Hispanic Whites, non-Hispanic Black and Hispanic persons were 1.4 (p = 0.003) and 2.4 (p<0.001) times more likely, respectively, to test positive. Compared to persons ages 18–24, the odds of testing positive were statistically significantly higher for every age group except 25–34, and those aged 65+ were 2.8 times more likely to test positive (p<0.001). Adjusted for race, sex, and age, COVID-positive patients with chronic obstructive pulmonary disease were 1.9 times more likely to require a ventilator compared to those without chronic obstructive pulmonary disease (p = 0.001). Length of stay was not statistically significantly associated with any of the comorbidity variables. Our findings emphasize the importance of documenting COVID-19 disparities in marginalized populations.

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Comprehensive analysis of in-hospital delirium after major surgical oncology procedures

Canadian Urological Association Journal ◽

10.5489/cuaj.6030 ◽

2019 ◽

Vol 14 (3) ◽

Author(s):

Marco Bandini ◽

Michele Marchioni ◽

Felix Preisser ◽

Sebastiano Nazzani ◽

Zhe Tian ◽

...

Keyword(s):

Risk Factors ◽

Length Of Stay ◽

Hospital Mortality ◽

Lung Resection ◽

Temporal Trends ◽

Surgical Oncology ◽

Population Based ◽

Hospital Charges ◽

Weighted Estimate ◽

Prolonged Length

Introduction: Very few population-based assessments of delirium have been performed to date. These have not assessed the implications of delirium after major surgical oncology procedures (MSOPs). We examined the temporal trends of delirium following 10 MSOPs, as well as patient and hospital delirium risk factors. Finally, we examined the effect of delirium on length of stay, in-hospital mortality, and hospital charges. Methods: We retrospectively identified patients who underwent prostatectomy, colectomy, cystectomy, mastectomy, gastrectomy, hysterectomy, nephrectomy, oophorectomy, lung resection, or pancreatectomy within the Nationwide Inpatient Sample (2003‒2013). We yielded a weighted estimate of 3 431 632 patients. Multivariable logistic regression (MLR) analyses identified the determinants of postoperative delirium, as well as the effect of delirium on length of stay, in-hospital mortality, and hospital charges. Results: Between 2003 and 2013, annual delirium rate increased from 0.7 to 1.2% (+6.0%; p<0.001). Delirium rates were highest after cystectomy (predicted probability [PP] 3.1%) and pancreatectomy (PP 2.6%) and lowest after prostatectomy (PP 0.15%) and mastectomy (PP 0.13%). Advanced age (odds ratio [OR] 3.80), maleness (OR 1.38), and higher Charlson comorbidity index (OR 1.20), as well as postoperative complications represent risk factors for delirium after MSOPs. Delirium after MSOP was associated with prolonged length of stay (OR 3.00), higher mortality (OR 1.15) and increased in-hospital charges (OR 1.13). Conclusions: No contemporary population-based assessments of delirium after MSOP have been reported. According to our findings, delirium after MSOP has a profound impact on patient outcomes that ranges from prolonged length of stay to higher mortality and increased in-hospital charges.

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Occupational exposures and exacerbations of asthma and COPD—A general population study

PLoS ONE ◽

10.1371/journal.pone.0243826 ◽

2020 ◽

Vol 15 (12) ◽

pp. e0243826

Author(s):

Stinna Skaaby ◽

Esben Meulengracht Flachs ◽

Peter Lange ◽

Vivi Schlünssen ◽

Jacob Louis Marott ◽

...

Keyword(s):

Molecular Weight ◽

General Population ◽

Confidence Interval ◽

Population Study ◽

Cox Regression ◽

Occupational Exposures ◽

Forced Expiratory Volume ◽

Airflow Limitation ◽

Chronic Obstructive ◽

General Population Study

Purpose Recent studies suggest that occupational inhalant exposures trigger exacerbations of asthma and chronic obstructive pulmonary disease, but findings are conflicting. Methods We included 7,768 individuals with self-reported asthma (n = 3,215) and/or spirometric airflow limitation (forced expiratory volume in 1 second (FEV1)/ forced expiratory volume (FVC) <0.70) (n = 5,275) who participated in The Copenhagen City Heart Study or The Copenhagen General Population Study from 2001–2016. Occupational exposure was assigned by linking job codes with job exposure matrices, and exacerbations were defined by register data on oral corticosteroid treatment, emergency care unit assessment or hospital admission. Associations between occupational inhalant exposure each year of follow-up and exacerbation were assessed by Cox regression with time varying exposure and age as the underlying time scale. Results Participants were followed for a median of 4.6 years (interquartile range, IQR 5.4), during which 870 exacerbations occurred. Exacerbations were not associated with any of the selected exposures (high molecular weight sensitizers, low molecular weight sensitizers, irritants or low and high levels of mineral dust, biological dust, gases & fumes or the composite variable vapours, gases, dusts or fumes). Hazards ratios ranged from 0.8 (95% confidence interval: 0.7;1.0) to 1.2 (95% confidence interval: 0.9;1.7). Conclusion Exacerbations of obstructive airway disease were not associated with occupational inhalant exposures assigned by a job exposure matrix. Further studies with alternative exposure assessment are warranted.

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New Nosocomephobia? Changes in Hospitalizations during the COVID-19 Pandemic

Frontiers of Economics in China ◽

10.54605/fec20210402 ◽

2021 ◽

Vol 16 (4) ◽

pp. 607-627

Author(s):

Fengman Dou ◽

◽

Mengna Luan ◽

Zhigang Tao ◽

Hongjie Yuan ◽

...

Keyword(s):

Health Care ◽

Length Of Stay ◽

Hospital Mortality ◽

Hospital Admissions ◽

Heart Diseases ◽

Malignant Neoplasms ◽

Adverse Impacts ◽

Equal Importance ◽

Indirect Impacts

While the coronavirus disease-2019 (COVID-19) pandemic directly caused millions of hospitalizations and deaths, its indirect impacts on people with other illnesses can be of equal importance. Using discharge records in a major Chinese megacity where there was a limited number of COVID-19 cases, we find significant declines in the number of hospital admissions for a whole spectrum of disease categories during the pandemic. The declines were larger in COVID-19 designated hospitals and top-grade hospitals. In-hospital mortality and length of stay (LOS) were higher for stroke, ischaemic heart diseases, and malignant neoplasms, while women delivering in hospitals had fewer C-sections and shorter LOS. Our results suggest that people avoided necessary hospitalization out of fear of being infected by COVID-19. To prevent the adverse impacts of delaying health care, policymakers should establish clear guidelines encouraging people to seek necessary care, especially during the reopening period.

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Childhood maltreatment and lung function: Findings from the general population

European Respiratory Journal ◽

10.1183/13993003.02882-2020 ◽

2020 ◽

pp. 2002882

Author(s):

Carsten Spitzer ◽

Ralf Ewert ◽

Henry Völzke ◽

Stefan Frenzel ◽

Stephan B. Felix ◽

...

Keyword(s):

Lung Function ◽

General Population ◽

Childhood Maltreatment ◽

Signs And Symptoms ◽

Airflow Limitation ◽

Chronic Obstructive ◽

Childhood Trauma Questionnaire ◽

Obstructive Pulmonary Disease ◽

Physical Neglect ◽

Medical Histories

ObjectiveCumulative evidence indicates that childhood maltreatment (CM) is linked to self-reported asthma and chronic obstructive pulmonary disease. However, the relation between CM and objective measures of lung function as determined by spirometry has not yet been assessed.MethodsMedical histories and spirometric lung function were taken in 1386 adults from the general population. Participants also completed the Childhood Trauma Questionnaire for the assessment of emotional, physical and sexual abuse as well as emotional and physical neglect.Results25.3% of the participants reported at least one type of CM. Among them, use of medication for obstructive airway diseases as well as typical signs and symptoms of airflow limitation were significantly more frequent than in the group without exposure to CM. Although participants with CM had numerically lower values for FEV1, FVC and PEF than those without, these differences were non-significant when accounting for relevant covariates like age, sex, height and smoking. Likewise, there were no differences in the FEV1/FVC ratio nor in the frequency of airflow limitation regardless of its definition. No specific type of CM was related to spirometrically determined parameters of lung function.ConclusionsOur findings call into question the association of CM with obstructive lung diseases as indicated by prior research relying on self-reported diagnoses. We consider several explanations for these discrepancies.

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Patient and Aneurysm Characteristics Predicting Prolonged Length of Stay After Elective Open AAA Repair in the Endovascular Era

Vascular and Endovascular Surgery ◽

10.1177/1538574417739747 ◽

2017 ◽

Vol 52 (1) ◽

pp. 5-10 ◽

Cited By ~ 3

Author(s):

Sergio Casillas-Berumen ◽

Florencia A. Rojas-Miguez ◽

Alik Farber ◽

Sevan Komshian ◽

Jeffrey A. Kalish ◽

...

Keyword(s):

Length Of Stay ◽

Chronic Obstructive ◽

Improvement Program ◽

Obstructive Pulmonary Disease ◽

Prolonged Length ◽

Type Iv ◽

Caucasian Race ◽

Risk Patients ◽

Aneurysm Repair ◽

Aortic Aneurysm Repair

Introduction: Open aortic aneurysm repair (AAA) repair can be resource intensive and associated with a prolonged length of stay (LOS). We sought to examine patient and aneurysm predictors of prolonged LOS to better identify those at risk in the preoperative setting. Methods: Patient data were obtained from the targeted AAA American College of Surgery National Surgical Quality Improvement Program database from 2012 to 2014 of patients undergoing open AAA repair. Multivariable logistic regression was used to determine predictors of prolonged postoperative LOS defined as greater than 10 days (75th percentile). Results: There were 1172 open AAA repairs identified. The majority (54%) of patients were older than 70 years and male (74%). Surgical approach was transperitoneal (70.9%) and retroperitoneal (29.1%). Aneurysms were 51.4% infrarenal, 33% juxtarenal, 5.7% pararenal, 7.4% suprarenal, and 2.5% type IV thoracoabdominal. Mean and median LOS were 9.1 ± 7.4 and 7 (0-72) days, respectively. Independently associated with extended LOS factors were visceral revascularization (odds ratio [OR]: 5.32, 95% confidence interval [CI]: 2.77-10.22, P < .001), type IV thoracoabdominal extent (OR: 3.09, 95% CI: 1.01-9.46, P = .048), suprarenal extent (OR: 1.89, 95% CI: 1.07-3.34, P = .029) and juxtarenal (OR: 1.43, 95% CI: 1.01-2.02, P = .004), non-Caucasian race (OR: 2.80, 95% CI: 1.77-4.41, P < .001), chronic obstructive pulmonary disease (OR: 1.76, 95% CI: 1.20-2.59, P = .004), not-from-home admission (OR: 1.91, 95% CI: 1.13-3.24), and age greater than 70 (OR: 1.49, 95% CI: 1.08-2.05, P = .014). Conclusion: We identified patient and aneurysm characteristics independently associated with protracted LOS following open AAA repair. Prospective identification of high-risk patients may allow physicians and hospitals to engage in multidisciplinary collaborations preoperatively to try to improve LOS in this resource-intensive population.

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Smoking, Systemic Inflammation, and Airflow Limitation: A Mendelian Randomization Analysis of 98 085 Individuals From the General Population

Nicotine & Tobacco Research ◽

10.1093/ntr/nty077 ◽

2018 ◽

Vol 21 (8) ◽

pp. 1036-1044 ◽

Cited By ~ 8

Author(s):

Yunus Çolak ◽

Shoaib Afzal ◽

Peter Lange ◽

Børge G Nordestgaard

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

General Population ◽

Pulmonary Disease ◽

Systemic Inflammation ◽

Tobacco Consumption ◽

Airflow Limitation ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

General Population Study ◽

Former Smokers

Abstract Introduction Smoking is associated with systemic and local inflammation in the lungs. Furthermore, in chronic obstructive pulmonary disease, which is often caused by smoking, there is often systemic inflammation that is linked to lung function impairment. However, the causal pathways linking smoking, systemic inflammation, and airflow limitation are still unknown. We tested whether higher tobacco consumption is associated with higher systemic inflammation, observationally and genetically and whether genetically higher systemic inflammation is associated with airflow limitation. Methods We included 98 085 individuals aged 20–100 years from the Copenhagen General Population Study; 36589 were former smokers and 16172 were current smokers. CHRNA3 rs1051730 genotype was used as a proxy for higher tobacco consumption and the IL6R rs2228145 genotype was used for higher systemic inflammation. Airflow limitation was defined as forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) <70%. Results Difference in plasma level of C-reactive protein was 4.8% (95% CI = 4.4% to 5.2%) per 10 pack-year increase and 1.6% (95% CI = 0.4% to 2.8%) per T allele. Corresponding differences were 1.2% (95% CI = 1.1% to 1.3%) and 0.5% (95% CI = 0.3% to 0.8%) for fibrinogen, 1.2% (95% CI = 1.2% to 1.3%) and 0.7% (95% CI = 0.5% to 1.0%) for α1-antitrypsin, 2.0% (95% CI = 1.8% to 2.1%) and 0.7% (95% CI = 0.4% to 1.1%) for leukocytes, 1.9% (95% CI = 1.8% to 2.1%) and 0.8% (95% CI = 0.4% to 1.2%) for neutrophils, and 0.8% (95% CI = 0.7% to 1.0%) and 0.4% (95% CI = 0.1% to 0.7%) for thrombocytes. The differences in these levels were lower for former smokers compared with current smokers. The IL6R rs2228145 genotype was associated with higher plasma acute-phase reactants but not with airflow limitation. Compared with the C/C genotype, the odds ratio for airflow limitation was 0.95 (95% CI = 0.89 to 1.02) for A/C genotype and 0.94 (95% CI = 0.87 to 1.01) for A/A genotype. Conclusions Higher tobacco consumption is associated with higher systemic inflammation both genetically and observationally, whereas systemic inflammation was not associated with airflow limitation genetically. Implications The association between higher tobacco consumption and higher systemic inflammation may be causal, and the association is stronger among current smokers compared to former smokers, indicating that smoking cessation may reduce the effects of smoking on systemic inflammation. Systemic inflammation does not seem to be a causal driver in development of airflow limitation. These findings can help to understand the pathogenic effects of smoking and the interplay between smoking, systemic inflammation, and airflow limitation and hence development and progression of chronic obstructive pulmonary disease.

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Time trends in hospital admissions in very elderly patients (≥85 years-old) in Spain: data from the Spanish National Discharge Database (2000 - 2015)

10.21203/rs.3.rs-54740/v2 ◽

2021 ◽

Author(s):

Sergio Palacios Fernández ◽

Mario Salcedo ◽

Gregorio Gonzalez-Alcaide ◽

Jose-Manuel Ramos-Rincon

Keyword(s):

Length Of Stay ◽

Elderly Patients ◽

Hospital Admissions ◽

Age Groups ◽

Chronic Obstructive ◽

Percentage Increase ◽

Very Elderly ◽

Data Set ◽

Obstructive Pulmonary Disease ◽

Neck Fracture

Abstract 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 very elderly inpatients (≥ 85 years) 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 admissions in very elderly patients in Spain from 2000 to 2015, representing 5.32% of total admissions 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 (37.3% to 39.7%, p<0.001), and they had a higher risk of hospitalization than women (385 discharges/1000 men versus 280 discharges/1000 women in 2012–2015).Mortality 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. Costs per hospital stay increased from 2000 to 2011, from EUR 4611 in 2000–2003 to EUR 5212 in 2008–2011, before dropping to EUR 4824 in 2012–2015. The 10 most frequent discharge diagnoses in the period 2000-2003 were: femoral neck fracture (8.07%), heart failure (7.84%), neoplasms (7.65%), ischemic encephalopathy (6.97%), pneumonia (6.36%), chronic obstructive pulmonary disease (4.23%), ischemic cardiomyopathy (4.2%), other respiratory diseases (3.87%), other alterations of urethra and the urinary tract (3.08%), and cholelithiasis (3.07%). Conclusions The very elderly population is growing in Spanish hospitals, and within this group, patients are getting older and more frequently male. M ean length of stay, cost of stay, and mortality are decreasing. Decompensation of chronic diseases, neoplasms and infections are the most common causes of admission.

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