Factores predictores de pérdida funcional al alta en ancianos hospitalizados por enfermedad aguda

Condorhuamán-Alvarado, Patricia Ysabel; Menéndez-Colino, Rocío; Mauleón-Ladrero, Coro; Díez‐Sebastián, Jesús; Alarcón, T.; González-Montalvo, Juan Ignacio

doi:10.1016/j.regg.2017.03.006

Cited by 6 publications

(6 citation statements)

References 14 publications

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“…Eighteen studies mentioned sociodemographic factors 5,8,15–30 ; 10 mentioned factors related to the hospital stay 15,16,25,30–36 ; 24 mentioned comorbidities as risk factors 8,9,15,16,23–26,30,32,33,37–48 ; and 10 discussed factors related to physiological reserve 9,26,30,32,37,39,40,49–51 . The individual factors identified are summarized in Figure 3.…”

Section: Resultsmentioning

confidence: 99%

“…In 22 studies, the endpoint was the degree of basic activities of Eighteen studies mentioned sociodemographic factors 5,8,[15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30] ; 10 mentioned factors related to the hospital stay 15,16,25,[30][31][32][33][34][35][36] ; 24 mentioned comorbidities as risk factors 8,9,15,16,[23][24][25][26]30,32,33,[37][38][39][40][41][42][43][44][45][46][47][48] ; and 10 discussed factors related to physiol...…”

Section: Methodological Aspectsmentioning

confidence: 99%

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Hospital‐associated deconditioning: Not only physical, but also cognitive

Chen

Almirall‐Sanchez

Mockler

et al. 2022

Int J Geriat Psychiatry

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Introduction: Hospital-associated deconditioning (HAD) or post-hospital syndrome is well recognized as reduced functional performance after an acute hospitalization.Recommendations for the management of HAD are still lacking, partly due to a poor understanding of the underlying processes. We aimed to review existing data on risk factors, pathophysiology, measurement tools, and potential interventions. Materials and methods:We conducted a systematic review from bibliographical databases in English, Spanish and French with keywords such as 'post-hospitalization syndrome' or 'deconditioning'. We selected studies that included people aged 60 years or older. Three researchers independently selected articles and assessed their quality. Results: From 4421 articles initially retrieved, we included 94 studies. Most were related to risk factors, trajectories and measures, and focused on the physical aspects of deconditioning. Risk factors for HAD included age, nutritional status, mobility, and pre-admission functional status, but also cognitive impairment and depression. Regarding interventions, almost all studies were devoted to physical rehabilitation and environmental modifications. Only one study focused on cognitive stimulation. Discussion: In the last decade, studies on HAD have mostly focused on the physical domain. However, neurological changes may also play a role in the pathophysiology of HAD. Beyond physical interventions, cognitive rehabilitation and neurological interventions should also be evaluated to improve deconditioning prevention and treatment in the hospital setting.

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Section: Resultsmentioning

confidence: 99%

Section: Methodological Aspectsmentioning

confidence: 99%

Hospital‐associated deconditioning: Not only physical, but also cognitive

Chen

Almirall‐Sanchez

Mockler

et al. 2022

Int J Geriat Psychiatry

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“…[10][11][12] Patient characteristics such as older age, female sex, frailty, lower functional or cognitive status at admission, comorbidities, and length of hospital stay are associated with the development of rehabilitation needs and functional impairments during hospital stays. [13][14][15] To prevent functional decline in vulnerable patients and other adverse outcomes such as institutionaliza-tion, various vulnerability screening instruments have been developed. [16][17][18] The vulnerability score of the mandatory Dutch Safety Management System (DSMS) was introduced in Dutch hospitals in 2012 and has been applied to all patients aged > 70 years at admission.…”

Section: Introductionmentioning

confidence: 99%

Association of Vulnerability Screening on Hospital Admission with Discharge to Rehabilitation-Oriented Care after Acute Hospital Stay

de Groot,

Wattel,

van Balen

et al. 2023

Ann Geriatr Med Res

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Background: We assessed the vulnerability of patients aged ≥70 years during hospital admission based on the Short Dutch Safety Management Screening (DSMS). Screening of four geriatric domains aims to prevent adverse outcomes and may support targeted discharge planning for post-acute care. We explored whether the DSMS criteria for acutely admitted patients were associated with rehabilitation-oriented care needs.Methods: This retrospective cohort study included community-dwelling patients aged ≥70 years acutely admitted to a tertiary hospital. We recorded patient demographics, morbidity, functional status, malnutrition, fall risk, and delirium and used descriptive analysis to calculate the risks by comparing the discharge destination groups. Results: Among 491 hospital discharges, 349 patients (71.1%) returned home, 60 (12.2%) were referred for geriatric rehabilitation, and 82 (16.7%) to other inpatient post-acute care. Non-home referrals increased with age from 21% (70–80 years) to 61% (>90 years). A surgical diagnosis (odds ratio [OR]=4.92; 95% confidence interval [CI], 2.03–11.95), functional decline represented by Katz-activities of daily living positive screening (OR=3.79; 95% CI, 1.76–8.14), and positive fall risk (OR=2.87; 95% CI, 1.31–6.30) were associated with non-home discharge. The Charlson Comorbidity Index did not differ significantly between the groups.Conclusion: Admission diagnosis and vulnerability screening outcomes were associated with discharge to rehabilitation-oriented care in patients >70 years of age. The usual care data from DSMS vulnerability screening can raise awareness of discharge complexity and provide opportunities to support timely and personalized transitional care.

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“…Hospitalization can, opposing to what people imagine, change the prognosis of older patients negatively by changing their life from independent to dependent. 1–4 The iatrogenic aspects of hospitalization, such as bed rest, are a burden for older patients resulting in an acceleration of problems related to aging and a loss of independence in basic self-care. That is why hospitalization is significantly associated with negative outcomes such as increased length of stay, increased risk of falls, and loss of capacity for self-care or activities of daily living, discharge into a nursing home, readmissions, and consequent mortality.…”

Section: Introductionmentioning

confidence: 99%

“…That is why hospitalization is significantly associated with negative outcomes such as increased length of stay, increased risk of falls, and loss of capacity for self-care or activities of daily living, discharge into a nursing home, readmissions, and consequent mortality. 4–8 These negative effects, such as decreased functional capacity and ability to perform daily life activities, occur even in short hospital stays (a few days). Functional decline at discharge when compared to the condition before admission to hospital is experienced by 30% to 60% of the older hospitalized patients and this decline is not related to the severity of the illness that led to hospitalization.…”

Section: Introductionmentioning

confidence: 99%

Effects of a nursing care program on functional outcomes in older acute medical in-patients: protocol for a randomized controlled trial

Rodrigues

Mendonça

Martins

2019

Porto Biomedical Journal

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Background: Hospitalization often leads to long periods of bed rest and inactivity which is associated with an increase in length of hospital stay, loss of capacity for basic self-care and discharge into a nursing home. Objective: This trial aims to verify if a nursing care program centered on basic self-care and predefined physical activity, improves functional outcomes in older hospitalized patients. Methods: This is a 2-group randomized controlled trial with repeated measures: 182 older acute medical patients will be blindly randomly allocated to the control group (n = 91) or intervention group (n = 91). The intervention will consist of nursing care intervention centered on basic self-care that includes a twice daily walking training, plus privileging pre-established trips to the toilet by walking and all daytime meals seated, off the bed. The main outcome was changes in the number of independent activities of daily living from 2 weeks before admission (baseline) to discharge. Trial registration: ClinicalTrials.gov (Identifier NCT03106064). Results: This intervention has the potential to change the outcomes of the older patient in the acute setting. Conclusion: The loss of independence in self-care is determinant in future health care needs. If our hypothesis is correct and demonstrate that this nursing care program centered on basic self-care for older acute medical patients improves functional outcomes, a change in the paradigmatic organization of hospital care may be justifiable.

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Factores predictores de pérdida funcional al alta en ancianos hospitalizados por enfermedad aguda

Cited by 6 publications

References 14 publications

Hospital‐associated deconditioning: Not only physical, but also cognitive

Hospital‐associated deconditioning: Not only physical, but also cognitive

Association of Vulnerability Screening on Hospital Admission with Discharge to Rehabilitation-Oriented Care after Acute Hospital Stay

Effects of a nursing care program on functional outcomes in older acute medical in-patients: protocol for a randomized controlled trial

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