Performance-based functional impairment and readmission and death: a prospective study.

Aubert, Carole Elodie; Folly, Antoine; Mancinetti, Marco; Hayoz, Daniel; Donzé, Jacques (2017). Performance-based functional impairment and readmission and death: a prospective study. BMJ open, 7(6), e016207. BMJ Publishing Group 10.1136/bmjopen-2017-016207

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OBJECTIVES Readmission and death are frequent after a hospitalisation and difficult to predict. While many predictors have been identified, few studies have focused on functional status. We assessed whether performance-based functional impairment at discharge is associated with readmission and death after an acute medical hospitalisation. DESIGN, SETTING AND PARTICIPANTS We prospectively included patients aged ≥50 years admitted to the Department of General Internal Medicine of a large community hospital. Functional status was assessed shortly before discharge using the Timed Up and Go test performed twice in a standard way by trained physiotherapists and was defined as a test duration ≥15 s. Sensitivity analyses using a cut-off at >10 and >20 s were performed. PRIMARY AND SECONDARY OUTCOME MEASURES The primary and secondary outcome measures were unplanned readmission and death, respectively, within 6 months after discharge. RESULTS Within 6 months after discharge, 107/338 (31.7%) patients had an unplanned readmission and 31/338 (9.2%) died. Functional impairment was associated with higher risk of death (OR 2.44, 95% CI 1.15 to 5.18), but not with unplanned readmission (OR 1.34, 95% CI 0.84 to 2.15). No significant association was found between functional impairment and the total number of unplanned readmissions (adjusted OR 1.59, 95% CI 0.95 to 2.67). CONCLUSIONS Functional impairment at discharge of an acute medical hospitalisation was associated with higher risk of death, but not of unplanned readmission within 6 months after discharge. Simple performance-based assessment may represent a better prognostic measure for mortality than for readmission.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Clinic of General Internal Medicine

UniBE Contributor:

Aubert, Carole Elodie and Donzé, Jacques

Subjects:

600 Technology > 610 Medicine & health

ISSN:

2044-6055

Publisher:

BMJ Publishing Group

Language:

English

Submitter:

Jacques Donzé

Date Deposited:

19 Feb 2018 14:26

Last Modified:

25 Feb 2018 02:24

Publisher DOI:

10.1136/bmjopen-2017-016207

PubMed ID:

28600376

Uncontrolled Keywords:

Timed Up and Go test death functional status readmission

BORIS DOI:

10.7892/boris.110659

URI:

https://boris.unibe.ch/id/eprint/110659

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