Variables asociadas a la recuperación funcional y la institucionalización al alta en ancianos ingresados en una unidad geriátrica de media estancia

Baztán, Juan J.; González, M.; Morales, Carlos; Vázquez, Eriberto Bauzá; Morón, N.; Forcano, Silvia; Ruipérez, Isidoro

doi:10.1016/s0014-2565(04)71550-7

Cited by 20 publications

(4 citation statements)

References 36 publications

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“…Instead of using absolute gain, they defined achieving functional recovery as an improvement in BI score of at least 30% of the maximum possible improvement from the score at admission (e.g., BI at admission = 70 points, maximum achievable BI = 100 points, so BI at discharge = 80 points indicates a 33% improvement, i.e., functional recovery achieved) in order to avoid a ceiling effect. Other groups have considered an absolute gain of ≥20 points on the BI as indicating functional recovery in geriatric patients [23].…”

Section: Discussionmentioning

confidence: 99%

Do older adults benefit from post-acute care following hospitalisation? A prospective cohort study at three Swiss nursing homes

et al. 2020

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BACKGROUND: Post-acute care (PAC) programmes appear favourable for older adult inpatients too fragile to be discharged home without extensive support, but otherwise not qualifying for specific rehabilitation. Consequently, many Swiss nursing homes have opened PAC wards after a new federal law refined reimbursement in 2012. However, PAC outcomes in this setting have not been well studied.OBJECTIVE: To investigate the functional outcomes of a nursing home-based PAC programme for older adult patients and to evaluate the influences of age, gender and frailty status on these outcomes. METHODS: This was a prospective cohort study in 135 consecutive patients aged 60 and older admitted to PAC at three nursing homes in Zurich, Switzerland, over a twomonth period. Geriatric assessment at admission included mobility, physical performance, cognition, nutrition, frailty, activities of daily living (ADL) and social support. The primary outcomes of the study, Short Physical Performance Battery (SPPB), handgrip strength (HGS) and Barthel Index (BI), were repeated before discharge from PAC. Multivariable linear models were used to analyse differences between these primary outcomes at admission and discharge, adjusting for baseline age, gender, BMI, length of stay (LOS), polypharmacy, cognition, and prior living status.RESULTS: We identified statistically significant improvements between admission and discharge (mean [95% confidence interval]; % change) in ]; +15.4%), gait speed (0.55 [0.48-0.62] vs 0.65 [0.58-0.71] m/s; +18.2%) and SPPB scores (5.5 [5.0-6.1] vs 6.9 [6.3-7.4]; +24%), p-values for all comparisons <0.001. CONCLUSIONS: In this real-word sample, PAC resulted in a significant and clinically relevant improvement in physical performance and ADL. However, our study should be replicated with a larger sample. Furthermore, long-term outcomes of PAC warrant additional investigation.

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Section: Discussionmentioning

confidence: 99%

Do older adults benefit from post-acute care following hospitalisation? A prospective cohort study at three Swiss nursing homes

et al. 2020

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“…The study includes sociodemographic variables (age and sex); variables related to the care process, such as hospitalization unit, type of process (medical, surgical), type of admission (scheduled, urgent), main diagnosis, Charlson Comorbidity Index [25,26], pressure injury on admission (yes, no), and admission motivated by fall (yes, no); outcome variables that necessitate nursing care, such as falls, pressure injuries, and functional loss [27]; the test to be evaluated (VALENF instrument) and the reference tests (Barthel Index [28], Braden Index [29] and Downton scale [30]).…”

Section: Variables and Instrumentsmentioning

confidence: 99%

Diagnostic accuracy study of the VALENF instrument in hospitalization units for adults: a study protocol

González-Chordá,

Aleixos,

Reverter

et al. 2023

BMC Nurs

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Recently, the VALENF instrument, Nursing Assessment by its acronym in Spanish, was developed as a meta-tool composed of only seven items with a more parsimonious approach for nursing assessment in adult hospitalization units. This meta-tool integrates the assessment of functional capacity, the risk of pressure injuries and the risk of falls. The general objective of this project is to validate the VALENF instrument by studying its diagnostic accuracy against the instruments commonly used in nursing to assess functional capacity, the risk of pressure injuries and the risk of falls. An observational, longitudinal, prospective study is presented, with recruitment and random selection based on admissions to six adult hospitalization units of the Hospital Universitario de La Plana. The study population will be made up of patients hospitalized in these units. The inclusion criteria will be patients over 18 years of age with a nursing assessment within the first 24 h of admission and an expected length of stay greater than 48 h and who sign the informed consent form. The exclusion criteria will be transfers from other units or centers. A sample of 521 participants is estimated as necessary. The evaluation test will be the VALENF instrument, and the reference tests will be the Barthel, Braden and Downton indices. Sociodemographic variables related to the care process and results such as functional loss, falls or pressure injuries will be collected. The evolution of functional capacity, the risk of falls and the risk of pressure injuries will be analyzed. The sensitivity, specificity and positive predictive values of the VALENF instrument will be calculated and compared to those of the usual instruments. A survival analysis will be performed for pressure injuries, falls and patients with functional loss. The VALENF instrument is expected to have at least the same diagnostic validity as the original instruments.Trial registration The study will be retrospectively registered (ISRCTN 17699562, 25/07/2023).

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“…En este punto se ha documentado que los pacientes con una buena situación previa son 2,5 veces más susceptibles de recuperar su situación basal al alta; mientras que los pacientes que tienen un Barthel previo menor de 60 tienen mayor riesgo de deteriorarse durante la hospitalización y persistir con deterioro al egreso [11]. En este punto vale considerar el efecto suelo, el cual hace referencia a los pacientes que ingresan con una dependencia funcional muy severa y, por tanto, no pueden tener mayor deterioro durante la hospitalización.…”

Section: Factores De Riesgounclassified

Deterioro funcional hospitalario. Revisión y actualización con una perspectiva orientada a mejorar la calidad de atención del anciano

Rengifo

Chavarro-Carvajal

2017

UNIV.MED.

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ResumenEl deterioro funcional hospitalario se caracteriza por la pérdida de, al menos, una de las actividades básicas de la vida diaria con respecto a la funcionalidad previa al inicio de la enfermedad aguda. Tiene factores de riesgo asociados que son modificables durante la hospitalización y de ahí la importancia de la identificación temprana y la intervención oportuna. Por eso se debe conocer esta entidad clínica, debido a las complicaciones asociadas que se pueden presentar tanto a corto como a largo plazo, entre las cuales están aumento de la estancia hospitalaria, presencia de complicaciones médicas, mayor riesgo de institucionalización, mayores costos para el sistema de salud y aumento de la mortalidad. El objetivo de esta revisión es conocer la forma de presentación, los factores de riesgo, la identificación temprana y los programas de intervención para mejorar la calidad de atención en los pacientes ancianos hospitalizados por enfermedad médica.

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Variables asociadas a la recuperación funcional y la institucionalización al alta en ancianos ingresados en una unidad geriátrica de media estancia

Cited by 20 publications

References 36 publications

Do older adults benefit from post-acute care following hospitalisation? A prospective cohort study at three Swiss nursing homes

Do older adults benefit from post-acute care following hospitalisation? A prospective cohort study at three Swiss nursing homes

Diagnostic accuracy study of the VALENF instrument in hospitalization units for adults: a study protocol

Deterioro funcional hospitalario. Revisión y actualización con una perspectiva orientada a mejorar la calidad de atención del anciano

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