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Mesina RS, Rustøen T, Hagen M, Laake JH, Hofsø K. Long-term functional disabilities in intensive care unit survivors: A prospective cohort study. Aust Crit Care 2024; 37:843-850. [PMID: 38171986 DOI: 10.1016/j.aucc.2023.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 11/16/2023] [Accepted: 11/26/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Functional disabilities are common in intensive care unit (ICU) survivors and may affect their ability to live independently. Few previous studies have investigated long-term functional outcomes with health status before ICU admission (pre-ICU health), and they are limited to specific patient groups. OBJECTIVES The objective of this study was to investigate the prevalence of functional disabilities and examine pre-ICU health variables as possible predictive factors of functional disabilities 12 months after ICU admission in a mixed population of ICU survivors. METHODS This prospective cohort study was conducted in six ICUs in Norway. Data on pre-ICU health were collected as soon as possible after ICU admission using patients, proxies, and patient electronic health records and at 12 months after ICU admission. Self-reported functional status was assessed using the Katz Index of independence in personal activities of daily living (P-ADL) and the Lawton instrumental activities of daily living scale (I-ADL). RESULTS A total of 220 of 343 (64%) ICU survivors with data on pre-ICU health completed the questionnaires at 12 months and reported the following functional disabilities at 12 months: 31 patients (14.4%) reported P-ADL dependencies (new in 16 and persisting in 15), and 80 patients (36.4%) reported I-ADL dependencies (new in 41 and persisting in 39). In a multivariate analysis, worse baseline P-ADL and I-ADL scores were associated with dependencies in P-ADLs (odds ratio [OR]: 1.87; 95% confidence interval [CI]: 1.14-3.06) and I-ADLs (OR: 1.52; 95% CI: 1.03-2.23), respectively, at 12 months. Patients who were employed were less likely to report I-ADL dependencies at 12 months (OR: 0.34; 95% CI: 0.12-0.95). CONCLUSION In a subsample of ICU survivors, patients reported functional disabilities 12 months after ICU admission, which was significantly associated with their pre-ICU functional status. Early screening of pre-ICU functional status may help identify patients at risk of long-term functional disabilities. ICU survivors with pre-ICU functional disabilities may find it difficult to improve their functional status.
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Affiliation(s)
- Renato S Mesina
- Department of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital, P.O. Box 4950, Nydalen N-0424, Oslo, Norway; Department of Public Health Science, Institute of Health and Society, Faculty of Medicine, University of Oslo, P.O. Box 1078, Blindern NO-0316, Oslo, Norway.
| | - Tone Rustøen
- Department of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital, P.O. Box 4950, Nydalen N-0424, Oslo, Norway; Department of Public Health Science, Institute of Health and Society, Faculty of Medicine, University of Oslo, P.O. Box 1078, Blindern NO-0316, Oslo, Norway
| | - Milada Hagen
- Department of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital, P.O. Box 4950, Nydalen N-0424, Oslo, Norway; Department of Public Health, Faculty of Nursing Science, Oslo Metropolitan University, P.O. Box 4, St. Olavs Plass N-0130, Oslo, Norway
| | - Jon Henrik Laake
- Department of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital, P.O. Box 4950, Nydalen N-0424, Oslo, Norway; Department of Anaesthesiology and Intensive Care Medicine, Division of Emergencies and Critical Care, Oslo University Hospital, P.O. Box 4950, Nydalen N-0424, Oslo, Norway
| | - Kristin Hofsø
- Department of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital, P.O. Box 4950, Nydalen N-0424, Oslo, Norway; Department of Postoperative and Intensive Care Nursing, Division of Emergencies and Critical Care, Oslo University Hospital, P. O. Box 4950, Nydalen N-0424, Oslo, Norway; Lovisenberg Diaconal University College, Lovisenberggt. 15b, 0456, Oslo, Norway
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Zhou J, Xu Y, Yang D, Zhou Q, Ding S, Pan H. Risk prediction models for disability in older adults: a systematic review and critical appraisal. BMC Geriatr 2024; 24:806. [PMID: 39358747 PMCID: PMC11448436 DOI: 10.1186/s12877-024-05409-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2024] [Accepted: 09/25/2024] [Indexed: 10/04/2024] Open
Abstract
BACKGROUND The amount of prediction models for disability in older adults is increasing but the prediction performance of different models varies greatly, and the quality of prediction models is still unclear. OBJECTIVES To systematically review and critically appraise the studies on risk prediction models for disability in older adults. METHODS A systematic literature search was conducted on PubMed, Embase, Web of Science, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL), China National Knowledge Infrastructure (CNKI), China Science and Technology Journal Database (VIP), and Wanfang Database, published up until June 30, 2023. Data were extracted according to the Checklist for critical Appraisal and data extraction for systematic Reviews of prediction Modelling Studies (CHARMS). The Prediction Model Risk of Bias Assessment Tool (PROBAST) was used to assess the risk of bias and applicability of the included studies. In addition, all included studies were evaluated for clinical value. RESULTS A total of 5722 articles were initially retrieved from databases, 16 studies and 17 prediction models were finally included after screening. The sample sizes of studies ranged from 420 to 90,889. Model development methods mainly included logistic regression analysis, Cox proportional hazards regression, and machine learning methods. The C statistic or area under the curve (AUC) of models ranged from 0.650 to 0.853, and nine models had C statistic/AUC higher than 0.75. Age, chronic disease, gender, self-rated health, body mass index (BMI), drinking, smoking and education level were the most common predictors. According to the PROBAST, all included studies were at high risk of bias, and 10 studies were at high concerns for applicability. Only two studies reported following the Transparent Reporting of a Multivariate Prediction Model for Individual Prognosis or Diagnosis (TRIPOD) statement. After evaluation, only two models reached the standard of clinical value. CONCLUSION Although most of the included prediction models had acceptable discrimination, the overall quality and clinical value of the current studies were poor. In the future, researchers should follow the TRIPOD statement and PROBAST checklist to develop prediction models with larger sample sizes, more reasonable study designs, and more scientific analysis methods, to improve the predictive performance and application value. TRIAL REGISTRATION The review protocol was registered in PROSPERO (registration ID: CRD42023446657).
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Affiliation(s)
- Jinyan Zhou
- Nursing Department, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, 3 Qingchun East Road, Hangzhou, 310016, China
| | - Yihong Xu
- Nursing Department, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, 3 Qingchun East Road, Hangzhou, 310016, China
| | - Dan Yang
- Nursing Department, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, 3 Qingchun East Road, Hangzhou, 310016, China
| | - Qianya Zhou
- School of Nursing, Zhejiang Chinese Medical University, Hangzhou, China
| | - Shanni Ding
- Nursing Department, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, 3 Qingchun East Road, Hangzhou, 310016, China
| | - Hongying Pan
- Nursing Department, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, 3 Qingchun East Road, Hangzhou, 310016, China.
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Gordon MJ, Duan Z, Zhao H, Nastoupil L, Iyer S, Ferrajoli A, Danilov AV, Giordano SH. Comparison of Comorbidity Models Within a Population-Based Cohort of Older Adults With Non-Hodgkin Lymphoma. JCO Clin Cancer Inform 2024; 8:e2300223. [PMID: 38684043 PMCID: PMC11476108 DOI: 10.1200/cci.23.00223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 01/25/2024] [Accepted: 03/08/2024] [Indexed: 05/02/2024] Open
Abstract
PURPOSE Compare the association of individual comorbidities, comorbidity indices, and survival in older adults with non-Hodgkin lymphoma (NHL), including in specific NHL subtypes. METHODS Data source was SEER-Medicare, a population-based registry of adults age 65 years and older with cancer. We included all incident cases of NHL diagnosed during 2008-2017 who met study inclusion criteria. Comorbidities were classified using the three-factor risk estimate scale (TRES), Charlson comorbidity index (CCI), and National Cancer Institute (NCI) comorbidity index categories and weights. Overall survival (OS) and lymphoma-specific survival, with death from other causes treated as a competing risk, were estimated using the Kaplan-Meier method from time of diagnosis. Multivariable Cox models were constructed, and Harrel C-statistics were used to compare comorbidity models. A two-sided P value of <.05 was considered significant. RESULTS A total of 40,486 patients with newly diagnosed NHL were included. Patients with aggressive NHL had higher rates of baseline comorbidity. Despite differences in baseline comorbidity between NHL subtypes, cardiovascular, pulmonary, diabetes, and renal comorbidities were frequent and consistently associated with OS in most NHL subtypes. These categories were used to construct a candidate comorbidity score, the non-Hodgkin lymphoma 5 (NHL-5). Comparing three validated comorbidity scores, TRES, CCI, NCI, and the novel NHL-5 score, we found similar associations with OS and lymphoma-specific survival, which was confirmed in sensitivity analyses by NHL subtypes. CONCLUSION The optimal measure of comorbidity in NHL is unknown. Here, we demonstrate that the three-category TRES and five-category NHL-5 scores perform as well as the 14-16 category CCI and NCI scores in terms of association with OS and lymphoma-specific survival. These simple scores could be more easily used in clinical practice without prognostic loss.
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Affiliation(s)
- Max J. Gordon
- The University of Texas MD Anderson Cancer Center, Department of Cancer Medicine, Houston, TX, USA
- National Cancer Institute, Lymphoid Malignancy Branch, Bethesda, MD, USA
| | - Zhigang Duan
- The University of Texas MD Anderson Cancer Center, Department of Health Services Research, Houston, TX, USA
| | - Hui Zhao
- The University of Texas MD Anderson Cancer Center, Department of Health Services Research, Houston, TX, USA
| | - Loretta Nastoupil
- The University of Texas MD Anderson Cancer Center, Department of Lymphoma and Myeloma, Houston, TX, USA
| | - Swaminathan Iyer
- The University of Texas MD Anderson Cancer Center, Department of Lymphoma and Myeloma, Houston, TX, USA
| | - Alessandra Ferrajoli
- The University of Texas MD Anderson Cancer Center, Department of Leukemia, Houston, TX, USA
| | - Alexey V. Danilov
- City of Hope National Medical Center, Department of Hematology & Hematopoietic Cell Transplantation, Duarte, CA, USA
| | - Sharon H. Giordano
- The University of Texas MD Anderson Cancer Center, Department of Health Services Research, Houston, TX, USA
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Gilbert T, Cordier Q, Polazzi S, Street A, Conroy S, Duclos A. Combining the Hospital Frailty Risk Score With the Charlson and Elixhauser Multimorbidity Indices to Identify Older Patients at Risk of Poor Outcomes in Acute Care. Med Care 2024; 62:117-124. [PMID: 38079225 PMCID: PMC10773558 DOI: 10.1097/mlr.0000000000001962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2024]
Abstract
OBJECTIVE The Hospital Frailty Risk Score (HFRS) can be applied to medico-administrative datasets to determine the risks of 30-day mortality and long length of stay (LOS) in hospitalized older patients. The objective of this study was to compare the HFRS with Charlson and Elixhauser comorbidity indices, used separately or combined. DESIGN A retrospective analysis of the French medical information database. The HFRS, Charlson index, and Elixhauser index were calculated for each patient based on the index stay and hospitalizations over the preceding 2 years. Different constructions of the HFRS were considered based on overlapping diagnostic codes with either Charlson or Elixhauser indices. We used mixed logistic regression models to investigate the association between outcomes, different constructions of HFRS, and associations with comorbidity indices. SETTING 743 hospitals in France. PARTICIPANTS All patients aged 75 years or older hospitalized as an emergency in 2017 (n=1,042,234).Main outcome measures: 30-day inpatient mortality and LOS >10 days. RESULTS The HFRS, Charlson, and Elixhauser indices were comparably associated with an increased risk of 30-day inpatient mortality and long LOS. The combined model with the highest c-statistic was obtained when associating the HFRS with standard adjustment and Charlson for 30-day inpatient mortality (adjusted c-statistics: HFRS=0.654; HFRS + Charlson = 0.676) and with Elixhauser for long LOS (adjusted c-statistics: HFRS= 0.672; HFRS + Elixhauser =0.698). CONCLUSIONS Combining comorbidity indices and HFRS may improve discrimination for predicting long LOS in hospitalized older people, but adds little to Charlson's 30-day inpatient mortality risk.
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Affiliation(s)
- Thomas Gilbert
- Department of Geriatric Medicine, Lyon University Hospitals (Hospices Civils de Lyon), Groupement Hospitalier sud, Lyon, France
- Research on Healthcare Professionals and Performance (RESHAPE, Inserm U1290), Université Claude Bernard Lyon 1, Lyon, France
| | - Quentin Cordier
- Health Data Department, Hospices Civils de Lyon, Lyon, France
| | - Stéphanie Polazzi
- Research on Healthcare Professionals and Performance (RESHAPE, Inserm U1290), Université Claude Bernard Lyon 1, Lyon, France
- Health Data Department, Hospices Civils de Lyon, Lyon, France
| | - Andrew Street
- Department of Health Policy, London School of Economics
| | - Simon Conroy
- MRC Unit for Lifelong Health and Ageing, University College London, London, UK
| | - Antoine Duclos
- Research on Healthcare Professionals and Performance (RESHAPE, Inserm U1290), Université Claude Bernard Lyon 1, Lyon, France
- Health Data Department, Hospices Civils de Lyon, Lyon, France
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Wang Y, Xu X, Liu J, Lv Q, Chang H, He Y, Zhao Y, Zhang X, Zang X. Latent transition analysis of instrumental activities of daily living in Chinese elderly: based on the 2014-2018 wave of the Chinese Longitudinal Healthy Longevity Survey. BMC Geriatr 2024; 24:83. [PMID: 38254009 PMCID: PMC10804623 DOI: 10.1186/s12877-023-04631-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 12/21/2023] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND The instrumental activities of daily living (IADL) among the elderly have been found to be heterogeneous, with different trajectories. However, the transition of the IADL over time remains unclear. We aimed to explore the transition probabilities and the predictors of IADL among the elderly. METHODS Longitudinal data from the 2014 (T1) and 2018 (T2) waves of the Chinese Longitudinal Healthy Longevity Survey were extracted. A sample of 2,944 participants aged 65 years or older, with complete responses to the IADL scale, was included. Latent profile analysis (LPA) and latent transition analysis (LTA) were employed to identify latent profiles of IADL and investigate the transition probabilities between profiles from T1 to T2. The predictors of latent profiles and transition probabilities were examined using multinomial regression analysis. RESULTS The results of LPA at both T1 and T2 supported a 4-profile model solution. They were labeled as the "Normal function profile," "Mildly impaired profile," "Moderately impaired profile," and "Highly impaired profile". The Normal function profile and Highly impaired profile were characterized by maintaining stability rather than transitioning over time, with transition probabilities of 0.71 and 0.68, respectively, for maintaining stability. The Mildly impaired profile and Moderately impaired profile were characterized by a stronger tendency towards transition rather than stability, with transition probabilities of 0.29 and 0.45, respectively, of transitioning to the Highly impaired profile. The transition probabilities from the three impaired function profiles to the Normal function profile ranged from 0.05 to 0.19. Age, gender, place of residence, and social participation were significant predictors of profile attribution at T1 and transition probabilities over time. CONCLUSIONS This study employed the LTA to examine the transition probability of IADL among the Chinese elderly. By recognizing the different profiles of IADL and understanding the factors associated with transitions among the elderly, interventions can be tailored to improve their functional independence and successful reintegration into families and society.
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Affiliation(s)
- Yaqi Wang
- School of Nursing, Tianjin Medical University, No. 22 Qixiangtai Road, Heping District, 300070, Tianjin, China
| | - Xueying Xu
- School of Nursing, Tianjin Medical University, No. 22 Qixiangtai Road, Heping District, 300070, Tianjin, China
| | - Jingwen Liu
- School of Nursing, Tianjin Medical University, No. 22 Qixiangtai Road, Heping District, 300070, Tianjin, China
| | - Qingyun Lv
- School of Nursing, Tianjin Medical University, No. 22 Qixiangtai Road, Heping District, 300070, Tianjin, China
| | - Hairong Chang
- School of Nursing, Tianjin Medical University, No. 22 Qixiangtai Road, Heping District, 300070, Tianjin, China
| | - Yuan He
- School of Nursing, Tianjin Medical University, No. 22 Qixiangtai Road, Heping District, 300070, Tianjin, China
| | - Yue Zhao
- School of Nursing, Tianjin Medical University, No. 22 Qixiangtai Road, Heping District, 300070, Tianjin, China
| | - Xiaonan Zhang
- School of Nursing, Tianjin Medical University, No. 22 Qixiangtai Road, Heping District, 300070, Tianjin, China.
| | - Xiaoying Zang
- School of Nursing, Tianjin Medical University, No. 22 Qixiangtai Road, Heping District, 300070, Tianjin, China.
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Noguchi-Watanabe M, Ishikawa T, Ikuta K, Aishima M, Nonaka S, Takahashi K, Anzai T, Fukui S. Physical function decline predictors in nursing home residents using new national quality indicators. Geriatr Gerontol Int 2024; 24:123-132. [PMID: 38069652 DOI: 10.1111/ggi.14763] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 10/02/2023] [Accepted: 11/19/2023] [Indexed: 01/05/2024]
Abstract
AIM To determine the predictors of physical function (PF) decline among nursing home residents using items from the Long-term care Information system For Evidence (LIFE), a system launched in 2021 to ensure the quality of long-term care. METHODS The LIFE data of 1648 residents from 45 nursing homes in Japan were retrospectively collected in July 2021 (T0) and January 2022 (T1), including demographics, PF assessed by the Barthel index (BI), nutrition and oral health, and cognitive function. The Dementia Behavior Disturbance scale was used to assess the frequency of certain behaviors, such as "waking at midnight." The predictors of PF decline, defined as a decrease ≥5 in the BI score at T1 compared with that at T0, were determined using mixed-effects logistic regression analyses. PF at T0 was classified into high (>60 BI) and low (≤60 BI) groups. RESULTS The participants' mean age was 87.2 ± 7.1 years, and 45.3% experienced PF decline. The significant predictors of PF decline were age ≥ 90 years, body mass index <18.5 kg/m2 , dementia diagnosis, moderate and severe cognitive impairments, not vocalizing reciprocal exchanges at will, always "waking at midnight," and high PF at T0. CONCLUSIONS The LIFE items predicted PF decline among nursing home residents, suggesting that LIFE data can be used to ensure the quality of long-term care. Geriatr Gerontol Int 2024; 24: 123-132.
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Affiliation(s)
- Maiko Noguchi-Watanabe
- Department of Home and Palliative Care Nursing, Graduate School of Health Care Sciences, Tokyo Medical and Dental University, Bunkyo-ku, Japan
| | - Takako Ishikawa
- Department of Home and Palliative Care Nursing, Graduate School of Health Care Sciences, Tokyo Medical and Dental University, Bunkyo-ku, Japan
| | - Kasumi Ikuta
- Department of Home and Palliative Care Nursing, Graduate School of Health Care Sciences, Tokyo Medical and Dental University, Bunkyo-ku, Japan
| | - Miya Aishima
- Department of Home and Palliative Care Nursing, Graduate School of Health Care Sciences, Tokyo Medical and Dental University, Bunkyo-ku, Japan
| | - Sayuri Nonaka
- Department of Home and Palliative Care Nursing, Graduate School of Health Care Sciences, Tokyo Medical and Dental University, Bunkyo-ku, Japan
| | - Kunihiko Takahashi
- Department of Biostatistics, M&D Data Science Center, Tokyo Medical and Dental University, Tokyo, Japan
| | - Tatsuhiko Anzai
- Department of Biostatistics, M&D Data Science Center, Tokyo Medical and Dental University, Tokyo, Japan
| | - Sakiko Fukui
- Department of Home and Palliative Care Nursing, Graduate School of Health Care Sciences, Tokyo Medical and Dental University, Bunkyo-ku, Japan
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Soh CH, Lim WK, Maier AB. Predictors for the Transitions of Poor Clinical Outcomes Among Geriatric Rehabilitation Inpatients. J Am Med Dir Assoc 2022; 23:1800-1806. [PMID: 35760091 DOI: 10.1016/j.jamda.2022.05.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 05/09/2022] [Accepted: 05/22/2022] [Indexed: 10/17/2022]
Abstract
OBJECTIVE To investigate the associations of morbidity burden and frailty with the transitions between functional decline, institutionalization, and mortality. DESIGN REStORing health of acutely unwell adulTs (RESORT) is an ongoing observational, longitudinal inception cohort and commenced on October 15, 2017. Consented patients were followed for 3 months postdischarge. SETTING AND PARTICIPANTS Consecutive geriatric rehabilitation inpatients admitted to geriatric rehabilitation wards. METHODS Patients' morbidity burden was assessed at admission using the Charlson Comorbidity Index (CCI) and Cumulative Illness Rating Scale (CIRS). Frailty was assessed using the Clinical Frailty Scale (CFS) and modified Frailty Index based on laboratory tests (mFI-lab). A multistate model was applied at 4 time points: 2 weeks preadmission, admission, and discharge from geriatric rehabilitation and 3 months postdischarge, with the following outcomes: functional decline, institutionalization, and mortality. Cox proportional hazards regression was applied to investigate the associations of morbidity burden and frailty with the transitions between outcomes. RESULTS The 1890 included inpatients had a median age of 83.4 (77.6-88.4) years, and 56.3% were female. A higher CCI score was associated with a greater risk of transitions from preadmission and declined functional performance to mortality [hazard ratio (HR) 1.28, 95% CI 1.03-1.59; HR 1.32, 95% CI 1.04-1.67]. A higher CIRS score was associated with a higher risk of not recovering from functional decline (HR 0.80, 95% CI 0.69-0.93). A higher CFS score was associated with a greater risk of transitions from preadmission and declined functional performance to institutionalization (HR 1.28, 95% CI 1.10-1.49; HR 1.23, 95% CI 1.04-1.44) and mortality (HR 1.12, 95% CI 1.01-1.33; HR 1.11, 95% CI 1.003-1.31). The mFI-lab was not associated with any of the transitions. None of the morbidity measures or frailty assessment tools were associated with the transitions from institutionalization to other outcomes. CONCLUSIONS AND IMPLICATIONS This study demonstrates that greater frailty severity, assessed using the CFS, is a significant risk factor for poor clinical outcomes and demonstrates the importance of implementing it in the geriatric rehabilitation setting.
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Affiliation(s)
- Cheng Hwee Soh
- Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia
| | - Wen Kwang Lim
- Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia
| | - Andrea B Maier
- Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia; Department of Human Movement Sciences, @AgeAmsterdam, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, the Netherlands; Healthy Longevity Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Centre for Healthy Longevity, @AgeSingapore, National University Health System, Singapore.
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Soh CH, Hassan SWU, Sacre J, Lim WK, Maier AB. Do morbidity measures predict the decline of activities of daily living and instrumental activities of daily living amongst older inpatients? A systematic review. Int J Clin Pract 2021; 75:e13838. [PMID: 33202078 PMCID: PMC8047900 DOI: 10.1111/ijcp.13838] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 11/05/2020] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVES Older adults often suffer from multimorbidity, which results in hospitalisations. These are often associated with poor health outcomes such as functional dependence and mortality. The aim of this review was to summarise the current literature on the capacities of morbidity measures in predicting activities of daily living (ADL) and instrumental activities of daily living (IADL) amongst inpatients. METHODS A systematic literature search was performed using four databases: Medline, Cochrane, Embase, and Cinahl Central from inception to 6th March 2019. Keywords included comorbidity, multimorbidity, ADL, and iADL, along with specific morbidity measures. Articles reporting on morbidity measures predicting ADL and IADL decline amongst inpatients aged 65 years or above were included. RESULTS Out of 7334 unique articles, 12 articles were included reporting on 7826 inpatients (mean age 77.6 years, 52.7% females). Out of five morbidity measures, the Charlson Comorbidity Index was most often reported. Overall, morbidity measures were poorly associated with ADL and IADL decline amongst older inpatients. CONCLUSION Morbidity measures are poor predictors for ADL or IADL decline amongst older inpatients and follow-up duration does not alter the performance of morbidity measures.
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Affiliation(s)
- Cheng Hwee Soh
- Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Melbourne, VIC, Australia
| | - Syed Wajih Ul Hassan
- Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Melbourne, VIC, Australia
| | - Julian Sacre
- Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Melbourne, VIC, Australia
| | - Wen Kwang Lim
- Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Melbourne, VIC, Australia
| | - Andrea B Maier
- Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Melbourne, VIC, Australia
- Department of Human Movement Sciences, @AgeAmsterdam, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, the Netherlands
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