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Introduction Le syndrome de glissement est un concept gériatrique français controversé mais encore utilisé en pratique clinique [1]. Il désigne une détérioration globale physique et psychique, sans cause organique évidente [2]. Objectifs Décrire le parcours hospitalier et le profil des patients âgés hospitalisés pour syndrome de glissement, ainsi que les facteurs associés à la mortalité post-hospitalière. Méthode Étude rétrospective, observationnelle, monocentrique incluant 419 patients âgés de 75 ans et plus, hospitalisés entre 2019 et 2023 à l’Assistance publique – hôpitaux de Marseille. Les patients ont été identifiés dans le PMSI via le code CIM-11 R54 (« sénilité »). Résultats L’âge moyen était de 86,8 ans. Les patients étaient fragiles (CFS = 6), polypathologiques (Charlson = 7,3), dénutris (48,9 %) et polymédiqués dans 64 % des cas. L’usage de psychotropes était notable (antidépresseurs 33,4 %, benzodiazépines 31,3 %). La durée moyenne d’hospitalisation était de 14 jours. Les principales comorbidités étaient les infections (57,5 %), troubles ioniques (47 %) et maladies cardiovasculaires (33,9 %). La mortalité atteignait 22 % durant l’hospitalisation et 36 % dans les 30 jours suivant la sortie, mais restait plus faible après un passage en service de gériatrie (OR 0,58, IC 95% 0,35-0,95), p = 0,031).

Background Geriatric “failure to thrive” (French “syndrome de glissement”) remains used in practice despite limited nosological validity. Objective. To describe care pathways and the clinical, social and biological profiles of older adults hospitalized for “failure to thrive”, and to identify factors associated with short-term mortality. Methods Retrospective, observational, single-center study including 419 patients aged ≥ 75 years admitted between 2019 and 2023 to the Assistance Publique–Hôpitaux de Marseille. Cases were retrieved from the French hospital discharge database using ICD-11 R54. We extracted demographics, comorbidities, geriatric syndromes, medications and admission laboratories; outcomes were in-hospital death and 30-day post-discharge death. Descriptive statistics and multivariable logistic regression were performed. Results Median age was 86; patients were markedly frail (mean Clinical Frailty Scale 6.0) with high comorbidity burden (mean Charlson 7.3). Malnutrition affected 48.9%; polypharmacy (≥ 5 drugs) 64%; psychotropic use was common (antidepressants 33.4%, benzodiazepines 31.3%). Mean length of stay was 14 days. Frequent associated diagnoses included infections (57.5%), electrolyte disorders (47%) and cardiovascular diseases (33.9%). Mortality was 22% in-hospital and 36% within 30 days post-discharge. In multivariable analysis, 30-day mortality was independently associated with severe frailty (CFS ≥ 7; adjusted OR 1.89; 95%CI 1.20–2.95), malnutrition (1.72; 1.10–2.68) and CRP > 50 mg/L (1.63; 1.04–2.56), whereas admission to a geriatric unit was protective (0.58; 0.35–0.95). Conclusions Patients coded as “failure to thrive” represent an extremely vulnerable group with high early mortality rate. Findings support replacing this label with standardized multidimensional geriatric assessment, systematic nutritional management, medication review (including psychotropic deprescribing), and safer care transitions through dedicated geriatric pathways and early post-acute follow-up.