Predictors of adverse outcomes on an acute geriatric rehabilitation ward

Singh, Inderpal, Gallacher, John Edward ORCID: https://orcid.org/0000-0002-2394-5299, Davis, Karl, Johansen, Antony, Eeles, Eamonn and Hubbard, Ruth Eleanor 2012. Predictors of adverse outcomes on an acute geriatric rehabilitation ward. Age and Ageing 41 (2) , pp. 242-246. 10.1093/ageing/afr179

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Abstract

Background: multidisciplinary rehabilitation is of proven benefit in the management of older inpatients. However, the identification of patients who will do well with rehabilitation currently lacks a strong evidence base. Objectives: the aims of this study were to compare the importance of chorological age, gender, co-morbidities and frailty in the prediction of adverse outcomes for patients admitted to an acute geriatric rehabilitation ward. Design: prospective observational cohort study. Subjects and setting: two hundred and sixty-five patients admitted consecutively to an acute geriatric rehabilitation ward at a tertiary care teaching hospital. Methods: frailty status was measured by an index of accumulated deficits, giving a potential score from 0 (no deficits) to 1.0 (all 40 deficits present). Patients were stratified into three outcomes: good (discharged to original residence within 28 days), intermediate (discharged to original residence but longer hospital stay) and poor (newly institutionalised or died). Results: patients were old (82.6 ± 8.6 years) and frail (mean frailty index (FI) 0.34 ± 0.09). Frailty status correlated significantly with length of stay and was a predictor of poor functional gain. The odds ratio of intermediate and poor outcome relative to a good outcome was 4.95 (95% CI = 3.21, 7.59; P < 0.001) per unit increase in FI. Chronological age, gender and co-morbidity showed no significant association with outcomes. Conclusion: frailty is associated with adverse rehabilitation outcomes. The FI may have clinical utility, augmenting clinical judgement in the management of older inpatients.

Item Type:	Article
Status:	Published
Schools:	Medicine Systems Immunity Research Institute (SIURI)
Subjects:	R Medicine > R Medicine (General)
Uncontrolled Keywords:	frailty index, co-morbidity, aged, hospitals, rehabilitation, elderly
Publisher:	Oxford University Press
ISSN:	0002-0729
Last Modified:	21 Oct 2022 10:59
URI:	https://orca.cardiff.ac.uk/id/eprint/42042

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