Jg. Rodriguez et al., Functional impairment secondary to hospitalization due to acute disease inthe elderly. Analysis of incidence and associated risk factors, REV CLIN ES, 199(7), 1999, pp. 418-423
Objective. To determine the incidence of functional impairment at hospital
admission and after hospital discharge, and to identify those factors that
could be predictors of such impairment in a cohort of elderly people with h
igh level of independence in the basic activities of daily living (BADL).
Design. Epidemiologic, longitudinal and prospective study.
Setting. Acute Unit in a Geriatric Department.
Subjects. The follow-up population was made up by 150 subjects older than 6
5 years, admitted on account of acute medical conditions from December, 15t
h, 1995, to December, 15th, 1996, who were independent for walking and inde
pendent or with slight dependence for BADL.
Study parameters. All patients were evaluated at 48 hours after admission a
nd one month after discharge by means of a protocol including sociodemograp
hic, clinical, attending, functional and mental parameters.
Results. The incidence of functional impairment at hospital admission was 7
0.66%; such impairment persisted one month after discharge in 29.3% of subj
ects. The most involved activities related to motility. In the analysis of
crude data, the following parameters showed association with functional imp
airment risk one month after discharge: female sex (OR: 2.5), sensorial org
an pathology (OR: 2.6), hospital stay longer than 15 days (OR: 7.2), and La
wton Index score (38 +/- 2.6 in impaired patients us. 4.9 +/- 2 in non-impa
ired patients; p < 0.01). Barthel Index score at admission lower than 60 (O
R: 9.5), Cognitive Miniexam score lower than 28 (OR: 4.1), Informant Test s
core higher than 84 (OR: 2.5) and Geriatric Depression Scale score 9 (OR: 3
.1). In the logistic regression model, the following parameters remained as
Predictors of impairment: sex (OR: 3.3), days of hospital stay (OR: 2.3) a
nd Barthel Index score at admission (OR: 6.1) and Cognitive Miniexam score
(OR: 2.7).
Conclusions. For our population, sex, hospital stay days, functional impair
ment in Barthel Index at admission and Cognitive Miniexam score parameters
seem to behave as independent variables that can predict functional impairm
ent risk for BADL one month after discharge. These parameters could be usef
ul to select groups of elderly people with impairment risk, who could benef
it from specialized interventions leading to prevent/decrease functional im
pairment secondary to acute disease and hospitalization.