Timing and risk factors for functional changes associated with medical hospitalization in older patients

Mudge, AM, O'Rourke, P and Denaro, CP (2010) Timing and risk factors for functional changes associated with medical hospitalization in older patients. Journals of Gerontology - Series A Biological Sciences and Medical Sciences, 65A 8: 866-872. doi:10.1093/gerona/glq069


Author Mudge, AM
O'Rourke, P
Denaro, CP
Title Timing and risk factors for functional changes associated with medical hospitalization in older patients
Journal name Journals of Gerontology - Series A Biological Sciences and Medical Sciences   Check publisher's open access policy
ISSN 1079-5006
1758-535X
Publication date 2010-08
Sub-type Article (original research)
DOI 10.1093/gerona/glq069
Volume 65A
Issue 8
Start page 866
End page 872
Total pages 7
Place of publication Cary, NC, United States
Publisher Oxford University Press
Collection year 2011
Language eng
Formatted abstract
Background. Older medical patients often experience a decline in function associated with hospitalization. Some of this decline is already established at hospital admission, whereas some occurs during hospitalization. Objectives of this study were to separately describe pre-hospital and in-hospital functional changes in older Australian medical patients and to identify risk factors associated with these functional changes.

Methods. Secondary analysis of data from a prospective controlled trial conducted in general medical units of an Australian tertiary teaching hospital. Participants were 615 consecutive patients aged 65 years or older admitted under a general medical unit for more than 2 days, discharged alive, and not fully dependent at pre-admission baseline. Activities of daily living measured 2 weeks before admission, at admission, and at discharge were used to calculate rates of pre-hospital and in-hospital decline and of in-hospital recovery to pre-admission function. Potential predictors including age, sex, diagnosis, illness severity, pre-admission function, pre-admission supports, and documented "geriatric syndromes" (dementia, falls, malnutrition) were investigated for each functional change outcome using multiple logistic regression models.

Results. Sixty-four percent of participants had pre-hospital functional decline; only 42% of these had recovered to pre-admission function by hospital discharge. Only 7% had in-hospital decline. The different functional change variables had distinct patterns of predictors.

Conclusions. Most decline occurred prior to hospitalization and was associated with common indicators of poor outcomes in hospitalized elders. In-hospital decline was uncommon, suggesting that in-hospital recovery may be a more appropriate intervention target. © 2010 The Author.
Keyword Activities of daily living
Functional decline
Risk factors
Elderly-patients
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2011 Collection
School of Medicine Publications
 
Versions
Version Filter Type
Citation counts: TR Web of Science Citation Count  Cited 35 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 42 times in Scopus Article | Citations
Google Scholar Search Google Scholar
Created: Sun, 08 Aug 2010, 00:03:13 EST