Measuring Frailty in Inpatient Rehabilitation
Background In response to the global aging population, there has been increasing research on frailty. How frailty is conceptualized is shifting with the development of frailty models, especially in the acute care arena. Objective To explore frailty/vulnerability risk factors available at admission t...
Saved in:
Published in: | PM & R Vol. 12; no. 4; pp. 356 - 362 |
---|---|
Main Authors: | , , , |
Format: | Journal Article |
Language: | English |
Published: |
Hoboken, USA
John Wiley & Sons, Inc
01-04-2020
|
Online Access: | Get full text |
Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
Summary: | Background
In response to the global aging population, there has been increasing research on frailty. How frailty is conceptualized is shifting with the development of frailty models, especially in the acute care arena.
Objective
To explore frailty/vulnerability risk factors available at admission that were associated with salient patient outcomes within the context of inpatient rehabilitation.
Design
Methodologies in acute care are not easily adapted for a typical admission evaluation or a rehabilitation patient. In this study, the concept of frailty among patients admitted to rehabilitation was developed from risk factors available at admission that were associated with two patient outcomes, adverse hospital outcomes and 30‐day hospital readmissions.
Setting: Inpatient rehabilitation.
Patients
Data were included on all patients (n = 768) discharged from an inpatient rehabilitation unit of an academic medical center from 1 January 2012 through 31 December 2012.
Interventions
Not applicable.
Main Outcome Measure
Adverse events within the inpatient rehabilitation stay and 30‐day hospital readmissions.
Results
Significant independent factors associated with adverse events in the rehabilitation unit included African American (1.77 OR; 95% CI 1.06‐2.96), Hispanic (3.17 OR; 95% CI 1.13‐8.94), having >9 total comorbid conditions (1.44 OR; 95% CI 1.244‐1.66), and sphincter control domain (including bladder and bowel management) ≤ 9 FIM (0.92 OR; 95% CI 0.86‐0.98). For 30‐day readmission three variables were found to be significant: onset ≥7 days (2.31 OR; 95% CI 1.28‐4.22), requiring a tube for feeding (3.45 OR; 95% CI 1.433‐11.12), and being obese (4.72 OR; 95% CI 1.433‐15.58).
Conclusions
The findings highlight the need for early admission screening and identification of risk factors which can provide the time in the rehabilitation setting for the clinical team to treat and prevent the potential for poor outcomes. |
---|---|
Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
ISSN: | 1934-1482 1934-1563 |
DOI: | 10.1002/pmrj.12263 |