Risk Factors of Mortality in Emergency Admission of Phlebitis and Thrombophlebitis in Elderly Patients: A Retrospective Cohort of 8,911 Patients

Author Type(s)

Faculty

Document Type

Abstract

Publication Date

11-2021

DOI

10.1016/j.jamcollsurg.2021.08.645

Journal Title

Journal of the American College of Surgeons

Department

Surgery

Abstract

Introduction

This study examined the risk factors of in-hospital mortality in emergency admission of phlebitis and thrombophlebitis in elderly patients, National Inpatient Sample 2005-2014.

Methods

This retrospective cohort study extracted data on elderly patients with phlebitis and thrombophlebitis as a primary diagnosis who had an emergency admission. Multivariable backward generalized additive model (GAM) and multivariable backward logistic regression were conducted to evaluate the associations between mortality and hospital length of stay (HLOS) in emergently admitted elderly patients with the diagnosis of phlebitis and thrombophlebitis. The models were adjusted for confounders.

Results

Among the 8,911 elderly patients, 130 (1.46%) died. The mean (SD) age of survived vs. deceased ones was 77.87 (7.86) and 80.28 (7.85) years, respectively (p=0.001). Female patients comprised 60.5% of those who survived compared to 50.8% of those who died (p=0.02). The mean (SD) HLOS was 8.35 (4.63) days. A V-shaped association was observed in the GAM model between HLOS and mortality. HLOS of 3-6 days was associated with the lowest mortality rate (EDF=7.95, p<0.0001). The ascending branch of the V-shaped plot displayed a linear association between mortality and HLOS after a 4-day-hospitalization. A multivariable logistic model was built on the ascending part of the plot which showed an OR of 1.086 (1.051-1.122). Age, sex, CHF, coagulopathies, fluid and electrolyte abnormalities, renal failure, solid tumors, weight loss and metastasis were also significantly associated with mortality in the final model.

Conclusion

After day 4, each additional day staying in hospital increased the risk of mortality by 8.6%.

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