7
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Identifying elderly patients at risk of readmission after discharge from a short-stay unit in the emergency department using performance-based tests of daily activities

      research-article

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Background

          Readmission is a serious and adverse event for elderly patients. Despite efforts, predicting the risk of readmission remains imprecise. The objective of this study is to examine if performance-based tests of daily activities can identify elderly patients at risk of readmission within 26 weeks after discharge from a short-stay unit in the emergency department.

          Methods

          The current study is an observational study based on data from 144 elderly patients included in a previous non-randomised controlled trial. Before discharge, patients were assessed for limitations in performing daily activities using three performance-based tests with predetermined cut-off values: the Assessment of Motor and Process Skills, Timed Up and Go and the 30s-Chair Stand Test. Outcome was risk of readmission within 26 weeks after discharge.

          Results

          Limitations in performing daily activities were associated with risk of readmission as measured by the Assessment of Motor and Process Skills motor scale (Crude OR = 4.38 [1.36; 14.12]), (Adjusted OR = 4.17 [1.18; 14.75]) and the 30s-Chair Stand Test (Adjusted OR = 3.36 [1.42; 7.93]). No significant associations were found in regards to other measures.

          Conclusion

          The Assessment of Motor and Process Skills motor scale and the age, gender and comorbidity adjusted 30s-Chair Stand Test can identify elderly patients at increased risk of readmission after discharge from the emergency department. The results were limited by one-third of the patients did not perform the Assessment of Motor and Process Skills and the association between 30s-Chair Stand Test and risk of readmission were only positive when adjusted for age, gender and comorbidity.

          Related collections

          Most cited references33

          • Record: found
          • Abstract: found
          • Article: not found

          Development and validation of criterion-referenced clinically relevant fitness standards for maintaining physical independence in later years.

          To develop and validate criterion-referenced fitness standards for older adults that predict the level of capacity needed for maintaining physical independence into later life. The proposed standards were developed for use with a previously validated test battery for older adults-the Senior Fitness Test (Rikli, R. E., & Jones, C. J. (2001). Development and validation of a functional fitness test for community--residing older adults. Journal of Aging and Physical Activity, 6, 127-159; Rikli, R. E., & Jones, C. J. (1999a). Senior fitness test manual. Champaign, IL: Human Kinetics.). A criterion measure to assess physical independence was identified. Next, scores from a subset of 2,140 "moderate-functioning" older adults from a larger cross-sectional database, together with findings from longitudinal research on physical capacity and aging, were used as the basis for proposing fitness standards (performance cut points) associated with having the ability to function independently. Validity and reliability analyses were conducted to test the standards for their accuracy and consistency as predictors of physical independence. Performance standards are presented for men and women ages 60-94 indicating the level of fitness associated with remaining physically independent until late in life. Reliability and validity indicators for the standards ranged between .79 and .97. The proposed standards provide easy-to-use, previously unavailable methods for evaluating physical capacity in older adults relative to that associated with physical independence. Most importantly, the standards can be used in planning interventions that target specific areas of weakness, thus reducing risk for premature loss of mobility and independence.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Functional impairment and hospital readmission in Medicare seniors.

            Medicare currently penalizes hospitals for high readmission rates for seniors but does not account for common age-related syndromes, such as functional impairment.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Risk factors for hospital readmissions in elderly patients: a systematic review.

              Population ageing is associated with an increase in hospital admissions. Defining the factors that affect the risk of hospital readmission could identify individuals at high risk and enable targeted interventions to be designed. This aim of this study was to identify the risk factors for hospital readmission in elderly people. A systematic review of the literature published in English or Spanish was performed by electronically searching EMBASE, MEDLINE, CINAHL, SCI and SSCI. Some keywords were aged, elder, readmission, risk, etc. Selection criteria were: prospective cohort studies with suitable statistical analysis such as logistic regression, that explored the relationship between the risk of readmission with clinical, socio-demographic or other factors in elderly patients (aged at least 75 years) admitted to hospital. Studies that fulfilled these criteria were reviewed and data were extracted by two reviewers. We assessed the methodological quality of the studies and prepared a narrative synthesis. We included 12 studies: 11 were selected from 1392 articles identified from the electronic search and one additional reference was selected by manual review. Socio-demographic factors were only explanatory in a few models, while prior admissions and duration of hospital stay were frequently relevant factors in others. Morbidity and functional disability were the most common risk factors. The results demonstrate the need for increased vigilance of elderly patients who are admitted to hospital with specific characteristics that include previous hospital admissions, duration of hospital stay, morbidity and functional disability.
                Bookmark

                Author and article information

                Contributors
                lmn@via.dk
                Journal
                BMC Geriatr
                BMC Geriatr
                BMC Geriatrics
                BioMed Central (London )
                1471-2318
                22 June 2020
                22 June 2020
                2020
                : 20
                : 217
                Affiliations
                [1 ]GRID grid.154185.c, ISNI 0000 0004 0512 597X, Department of Physiotherapy and Occupational Therapy, , Aarhus University Hospital, ; Arhus, Denmark
                [2 ]GRID grid.460119.b, ISNI 0000 0004 0620 6405, Department of Occupational Therapy, , VIA University College, ; Aarhus, Denmark
                [3 ]GRID grid.7048.b, ISNI 0000 0001 1956 2722, Department of Public Health, , Aarhus University, ; Aarhus, Denmark
                [4 ]DEFACTUM, Central Denmark Region, Aarhus, Denmark
                [5 ]GRID grid.154185.c, ISNI 0000 0004 0512 597X, Research Centre for Emergency Medicine, , Aarhus University Hospital and Aarhus University, ; Aarhus, Denmark
                [6 ]Neurorehabilitation and Research Centre, Hammel, Denmark
                [7 ]GRID grid.10825.3e, ISNI 0000 0001 0728 0170, The Research Initiative for Activity Studies and Occupational Therapy, General Practice, Department of Public Health, , University of Southern Denmark, ; Odense, Denmark
                Author information
                http://orcid.org/0000-0002-3362-6275
                Article
                1591
                10.1186/s12877-020-01591-y
                7310017
                c5656e33-a408-493f-ab55-80624bf5d3f2
                © The Author(s) 2020

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 20 December 2019
                : 21 May 2020
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100007437, TrygFonden;
                Award ID: 107632
                Award Recipient :
                Funded by: FundRef http://dx.doi.org/10.13039/501100003035, Aase og Ejnar Danielsens Fond;
                Award ID: 10-001233
                Award Recipient :
                Funded by: Foundation of Public Health
                Award ID: 1-30-72-141-12
                Award Recipient :
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2020

                Geriatric medicine
                activity limitations,rehabilitation,readmission,elderly patients,emergency department,performance-based,measurement

                Comments

                Comment on this article