From the Guidelines
In frail bedridden geriatric patients, underlying causes of death can be complex and multifactorial. Examples of underlying causes related to immediate causes of death include:
- Cardiovascular disease as an underlying cause, contributing to immediate causes such as cardiac arrest, with underlying causes such as arrhythmias from electrolyte imbalances, myocardial infarction from atherosclerotic disease, or cardiac failure from hypertension or valvular disease 1.
- Malnutrition as an underlying cause, contributing to weakness, fatigue, and increased susceptibility to infections, with immediate causes such as pneumonia, sepsis, or organ failure 1.
- Dehydration as an immediate cause, with underlying causes such as inadequate fluid intake, excessive diuretic use, or hyperglycemia from uncontrolled diabetes 1.
- Chronic illnesses such as heart failure, with underlying causes such as comorbidities like diabetes, valvular disease, and obesity, contributing to immediate causes such as cardiac arrest or organ failure 1.
- Infections as an immediate cause, with underlying causes such as urinary tract infections from catheter use, skin breakdown from pressure ulcers, or respiratory infections from inadequate oral care.
It's essential to consider the patient's overall clinical context, including comorbidities, medications, and functional status, when determining the underlying causes of death in frail bedridden geriatric patients. The presence of comorbidities, such as diabetes and valvular disease, can increase the risk of mortality, as seen in the ESC-HF-LT registry 1. Additionally, malnutrition and dehydration can have serious health consequences, including increased susceptibility to infections and poor outcomes 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Underlying Causes of Death in Frail, Bedridden Geriatric Patients
The underlying causes of death related to immediate causes of death in frail, bedridden geriatric patients can be attributed to various factors. Some of the key factors include:
- Cerebrovascular disorders or other neurological disorders, which are major underlying diseases in patients with repeated pulmonary aspiration 2
- Dementia and deterioration of activities of daily living (ADL), which are common in patients with repeated pulmonary aspiration 2
- Immobility, which is associated with adverse outcomes in hospitalized patients, especially older people 3
- Urinary tract infection and pulmonary infection, which are significantly associated with 90-day mortality in bedridden patients 3
- Age, which is an independent risk factor for death in bedridden patients 3
Immediate Causes of Death
The immediate causes of death in frail, bedridden geriatric patients can be attributed to:
- Pneumonia, respiratory failure, and asphyxia, which are major causes of death in patients with repeated pulmonary aspiration 2
- Pulmonary infection, which is an independent risk factor for death in bedridden patients 3
- Aspiration pneumonia or aspiration bronchitis, which are common in patients with repeated pulmonary aspiration 2
Associated Factors
Other factors associated with death in frail, bedridden geriatric patients include:
- Frailty, which is a geriatric syndrome that affects 5% to 17% of older adults and is associated with adverse health outcomes 4
- Poor quality of life and high falling risk, which are issues commonly experienced with frailty 5
- Low activities of daily living (ADL) and being bedridden, which are common in patients with repeated pulmonary aspiration 2