Functional dependence predicts adverse outcomes among geriatric otolaryngology patients better than more complex risk scales: A multivariate analysis of hospitalization risks on elderly group

Małgorzata Wierzbicka^1,2,3Dorota Świątek^3*Andrzej Porębski⁴Jarosław Markowski⁵Katarzyna Ciuba⁵Maria Makuszewska⁶Kazimierz Niemczyk⁶Karolina Dzaman⁷Katarzyna Czerwaty⁷Bogusław Mikaszewski⁸Dominik Stodulski⁸Maciej Kawczyński⁹Magdalena Rękawek⁹Małgorzata Wierzchowska^10,11Joanna Czech¹¹Kamila Sroka¹²Wioletta Pietruszewska¹²

• ¹Faculty of Medicine, Wroclaw University of Science and Technology, Wroclaw, Poland, Wrocław, Poland
• ²Institute of Human Genetics, Polish Academy of Sciences, Poznan, Poland, Poznań, Poland
• ³Department of Otolaryngology, Regional Specialist Hospital Wroclaw, Research & Development Centre, Wrocław, Poland
• ⁴Faculty of Law and Administration, Jagiellonian University, Kraków, Poland
• ⁵Department of Laryngology, Faculty of Medical Sciences in Katowice, Medical University of Silesia in Katowice, Katowice, Poland
• ⁶Department of Otorhinolaryngology Head and Neck Surgery, Medical University of Warsaw, Warszawa, Poland
• ⁷Department of Otolaryngology, Centre of Postgraduate Medical Education, Warszawa, Poland
• ⁸Department of Otolaryngology, Faculty of Medicine, Medical University of Gdansk, Gdańsk, Poland
• ⁹Department of Otolaryngology, Pomeranian Medical University, Szczecin, Poland
• ¹⁰Department of Otolaryngology, Phoniatrics and Audiology, Nicolaus Copernicus University in Torun, Collegium Medicum in Bydgoszcz, Bydgoszcz, Poland
• ¹¹Department of Otolaryngology, Laryngological Oncology and Maxillofacial Surgery, University Hospital No2 in Bydgoszcz, Bydgoszcz, Poland
• ¹²Department of Otolaryngology Head Neck Oncology, Medical University of Lodz, Łódź, Poland

As the population of patients aged 80 and above continues to grows, otorhinolaryngology departments face increasing demands to manage complex and vulnerable older adults. In this multicenter retrospective study, we analyzed data from 426 hospitalized patients across eight university hospitals to identify predictors of prolonged hospitalization, 30-days serious complications, and 90-days functional decline. We found that physical inactivity (p < 0.001; p = 0.011; p = 0.004, respectively), dependence in daily functioning (p = 0.008; p < 0.001; p < 0.001), and impaired food intake (p < 0.001; p < 0.001; p = 0.002) were the most consistent and significant predictors of all three adverse outcomes. Traditional risk assessment tools, including the ASA and Caprini scores, showed limited predictive utility, with only the Charlson Comorbidity Index (CCI) offering meaningful additional value. Our findings underscore the importance of integrating functional status measures-such as mobility and food intake-into routine risk stratification to better identify high-risk geriatric inpatients and guide more personalized clinical management strategies.Introduction: