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...

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Bibliographic Details
Published in:PM & R Vol. 12; no. 4; pp. 356 - 362
Main Authors: Roberts, Pamela S., Aronow, Harriet U., Parker, Jordan, Riggs, Richard V.
Format: Journal Article
Language:English
Published: Hoboken, USA John Wiley & Sons, Inc 01-04-2020
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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.
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ISSN:1934-1482
1934-1563
DOI:10.1002/pmrj.12263