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Centre for Policy on Ageing | |
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| The prediction of functional decline in older hospitalised patients | | Author(s) | Jita G Hoogerduijn, Bianca M Buurman, Johanna C Korevaar |
| Journal title | Age and Ageing, vol 41, no 3, May 2012 |
| Pages | pp 381-387 |
| Source | http://ageing.oxfordjournals.org/ http://www.bgs.org.uk/ |
| Keywords | In-patients ; Discharge [hospitals] ; Self care capacity ; Ill health ; At risk ; Evaluation. |
| Annotation | Many older patients experience functional decline after hospitalisation, associated with an increase in dependence, readmission, nursing home placement and mortality. First step in prevention is the identification of patients at risk. The present study aimed to develop and validate a prediction model to assess the risk of functional decline in older hospitalised patients. Study participants were patients aged 65 years and above who were acutely admitted to hospital for at least 48 hours. Two studies took place: a development study based at two university hospitals and one regional hospital; and a validation study based in one university hospital. Both studies were followed up after three months. Functional decline was defined as a decline of at least one point on the Katz Activities of Daily Living (ADL) index at follow-up compared with pre-admission status. 35% of all patients in the development cohort and 32% in the validation cohort developed functional decline. A four-item model could accurately predict functional decline with an AUC of 0.71. At threshold 2 sensitivity, specificity, positive and negative predictive values were 87, 39, 43 and 85%, respectively. In the validation study, this was, respectively, 0.68, 89, 41, 41 and 89%. Pre-admission need for assistance in instrumental activities of daily living, use of a walking device, need for assistance in travelling and no education after age 14, are the items of a prediction model to identify older patients at risk for functional decline following hospital admission. The strength of the model is that it relies on four simple questions and this makes it easy to use in clinical practice and easy to administer. (JL). |
| Accession Number | CPA-120511007 A |
| Classmark | LF7: LD:QKJ: CA: CH: CA3: 4C |
Data © Centre for Policy on Ageing |
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| ...from the Ageinfo database published by Centre for Policy on Ageing. |
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