Every experienced physician has learned that when an elderly patient is confined to bed he is liable to become progressively weaker and die, despite the fact that his initial illness may not have been particularly serious. This complication is generally attributed to the development of hypostatic congestion, which predisposes the patient to bronchopneumonia. The precise nature of the disorder has received, however, relatively scant attention. In view of the clinical importance of the subject, the present study has been designed to clarify the mechanism by which prolonged recumbency exerts so harmful an effect on elderly persons and to indicate the fundamental principles of treatment.
The study of effects which are due exclusively to confinement to bed required subjects who were thus confined although in relatively good general health. The observations to be reported were therefore made on a series of thirty patients in the orthopedic wards of the Philadelphia
LAPLACE LB, NICHOLSON JT. PROLONGED RECUMBENCY AS A CONTRIBUTORY CAUSE OF DEATH IN ELDERLY PERSONS. JAMA. 1938;110(4):247–251. doi:10.1001/jama.1938.02790040001001