06 | Predictive factors of prolonged hospital stay in an acute geriatric ward

C. Candela¹, M. Matacena¹, M. Proni², P. Forti², F. Maioli¹ | ¹Ospedale Maggiore, UOC Rete Geriatrica Integrata Ospedale Territorio, Bologna; ²IRCSS Azienda Ospedaliero-Universitaria, Bologna.

Introduction. Hospitalization in older adults is associated with functional and cognitive decline and with a higher risk of in-hospital complications, all of which worsen as length of stay increases.

Objectives. To identify predictors of prolonged hospitalization in patients admitted to an acute Geriatric ward, in order to support early recognition, targeted interventions, ultimately preventing extended hospital stays.

Materials and Methods. This single-center retrospective cohort study included 441 patients aged ≥75 years admitted to the Acute Geriatric Ward of Maggiore Hospital, Bologna, between January and December 2024. Patients who died within 24 hours of admission and those transferred from other hospital wards were excluded. Demographic, clinical, functional and hospitalization-related variables, as well as discharge destination, were collected and analyzed.

Results. Patients were stratified according to length of stay, with prolonged hospitalization defined as ≥9 days. On univariate and multivariate analyses, no significant differences were observed between groups in demographic, clinical or socio-functional characteristics at admission. In contrast, prolonged hospitalization was significantly associated with the need for in-ward physiotherapy (p=0.001), social services support (p=0.03), previous hospitalization within the prior 6 months, and nosocomial infections. Discharge home, compared with discharge to other settings, was associated with shorter length of stay (p=0.004).

Conclusions. In this cohort of hospitalized older adults, prolonged stay was mainly associated with functional decline during hospitalization and with greater care needs. Early mobilization and timely identification of social frailty may help reduce complications and facilitate discharge home. These findings underscore the importance of multidisciplinary care in acute geriatric settings.