Hospital Admission Risk Profile (HARP): Identifying Older Patients at Risk for Functional Decline Following Acute Medical Illness and Hospitalization

Sager, Mark A.; Rudberg, Mark A.; Jalaluddin, Muhammad; Franke, Todd; Inouye, Sharon K.; Landefeld, C. Seth; Siebens, Hilary; Winograd, Carol H.

doi:10.1111/j.1532-5415.1996.tb00910.x

Cited by 358 publications

(350 citation statements)

References 33 publications

(53 reference statements)

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“…12,14,38,41,42 In older adults, who had the highest incidence of HAD in this cohort, agerelated factors may have played a greater role, such as more detrimental effects on function from acute illness and deconditioning associated with hospitalization. 36,[43][44][45] Consistent with other studies, cognitive impairment, which was highly prevalent in this population, was associated with the incidence of HAD, 35,46 and it was significantly associated with HAD in the youngest age group. As this was measured at admission, the high prevalence may be due in part to reversible causes such as delirium and reversible cognitive impairment, and may affect recovery.…”

Section: Discussionsupporting

confidence: 90%

Hospitalization-Associated Disability in Adults Admitted to a Safety-Net Hospital

et al. 2015

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BACKGROUND:Little is known about hospitalizationassociated disability (HAD) in older adults who receive care in safety-net hospitals. OBJECTIVES: To describe HAD and to examine its association with age in adults aged 55 and older hospitalized in a safety-net hospital. DESIGN: Secondary post hoc analysis of a prospective cohort from a discharge intervention trial, the Support from Hospital to Home for Elders. SETTING: Medicine, cardiology, and neurology inpatient services of San Francisco General Hospital, a safety-net hospital. PARTICIPANTS: A total of 583 participants 55 and older who spoke English, Spanish, or Chinese. We determined the incidence of HAD 30 days post-hospitalization and ORs for HAD by age group. MEASUREMENTS: The outcome measure was death or HAD at 30 days after hospital discharge. HAD is defined as a new or additional disability in one or more activities of daily living (ADL) that is present at hospital discharge compared to baseline. Participants' functional status at baseline (2 weeks prior to admission) and 30 days postdischarge was ascertained by self-report of ADL function. RESULTS: Many participants (75.3 %) were functionally independent at baseline. By age group, HAD occurred as follows: 27.4 % in ages 55-59, 22.2 % in ages 60-64, 17.4 % in ages 65-69, 30.3 % in ages 70-79, and 61.7 % in ages 80 or older. Compared to the youngest group, only the adjusted OR for HAD in adults over 80 was significant, at 2.45 (95 % CI 1.17, 5.15). CONCLUSIONS: In adults at a safety-net hospital, HAD occurred in similar proportions among adults aged 55-59 and those aged 70-79, and was highest in the oldest adults, aged ≥ 80. In safety-net hospitals, interventions to reduce HAD among patients 70 years and older should consider expanding age criteria to adults as young as 55.

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Section: Discussionsupporting

confidence: 90%

Hospitalization-Associated Disability in Adults Admitted to a Safety-Net Hospital

et al. 2015

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“…14,16 Além do número elevado de dias de internação, suficientes para a verificação de declínios funcionais, verificou-se associação significante entre os maiores comprometimentos funcionais e maiores dias de hospitalização. Percebendo a importância dessa variável como indicadora de qualidade de serviços hospitalares, institucionalização e dependência funcional, alguns estudos 18,22 têm-se dedicado a acompanhar mais de perto esses resultados. Sabendo-se ser essa uma realidade entre os idosos, há relatos de desenvolvimento de programas destinados a obter melhores resultados na internação de pacientes idosos e de alto risco.…”

Section: Discussionunclassified

Impacto funcional da internação hospitalar de pacientes idosos

et al. 2004

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Resumo ObjetivoDescrever as alterações da capacidade funcional de idosos durante a internação hospitalar e o grau de associação dessas alterações na ocasião da alta hospitalar a variáveis sociodemográficas e clínicas. Métodos Foram estudados 94 pacientes internados em enfermaria geriátrico gerontológica de um hospital escola, com idades entre 65 e 94 anos. A primeira avaliação da capacidade funcional (número de atividades cotidianas comprometidas) dos idosos foi realizada em até 24 horas da entrada do paciente e a última, imediatamente após a alta. Os pacientes sofreram intervenções terapêuticas rotineiras por equipe interdisciplinar. Os dados foram analisados pelo teste qui-quadrado, tanto para a linha de base como em relação à análise dos resultados obtidos com a internação hospitalar (α≤0,05). Resultados Dos pacientes estudados, 25,6% obtiveram melhora na capacidade funcional, 34,0% não sofreram alterações funcionais, 19,1% pioraram funcionalmente e 21,3% faleceram durante o período. Houve correlação significante entre a piora funcional e a presença déficit cognitivo, delirium e baixa capacidade funcional na entrada no hospital. Conclusões A capacidade funcional é um importante marcador de saúde em idosos hospitalizados. A melhora funcional durante a internação está associada a menores dificuldades nas atividades diárias referidas no momento da entrada no hospital e melhores condições clínicas. Abstract Objective

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“…Estes estudos têm discutido se a atuação sobre estes fatores teria impacto sobre a mortalidade, tempo de hospitalização e morbidade, incluindo a capacidade funcional e a qualidade de vida. [9][10][11][12] A identificação precoce dos fatores de risco para o declínio funcional em idosos hospitalizados pode fornecer subsídios à equipe de assistência hospitalar quanto à adequação de protocolos de avaliação, o direcionamento das intervenções e à identificação de grupos que se beneficiariam de intervenções geriátricas específicas, medidas que contribuiriam para a eficiência e qualidade dos serviços prestados. 7,13 Em virtude da extrema importância do tema, o objetivo do presente estudo foi a revisão crítica da literatura disponível sobre o declínio funcional associado à hospitalização em idosos e discutir os fatores a ele associados.…”

Section: Introductionunclassified

Fatores que predispõem ao declínio funcional em idosos hospitalizados

Cunha

Cintra

Cunha

et al. 2009

Rev. bras. geriatr. gerontol.

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Introduction: The increase in life expectancy is a global reality and determines the highest prevalence of chronic diseases and greater demand for health services, including hospitals. Currently, studies have focused on functional decline and its consequences -the demand for material and human resources, institutionalization and hospitalization. This paper aimed to critically review the available literature on the risk factors associated with functional decline in hospitalized elderly people. Methodology: Search the databases MEDLINE, LILACS and SciELO, in English and Portuguese between 2000 and 2007, using the key words hospital, elderly, functional status, aged and functional decline and references of selected articles.

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Hospital Admission Risk Profile (HARP): Identifying Older Patients at Risk for Functional Decline Following Acute Medical Illness and Hospitalization

Cited by 358 publications

References 33 publications

Hospitalization-Associated Disability in Adults Admitted to a Safety-Net Hospital

Hospitalization-Associated Disability in Adults Admitted to a Safety-Net Hospital

Impacto funcional da internação hospitalar de pacientes idosos

Fatores que predispõem ao declínio funcional em idosos hospitalizados

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