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Timing and risk factors for functional changes associated with medical hospitalization in older patients
Mudge AM, O'Rourke P, Denaro CP.. The journals of gerontology. Series A, Biological sciences and medical sciences, 2010-05-21
Topic: Risk, prevention and care in population studies
Background Older medical patients often experience a decline in function associated with hospitalization. Some of this decline is already established at hospital admission, whereas some occurs during hospitalization. Objectives of this study were to separately describe pre-hospital and in-hospital functional changes in older Australian medical patients and to identify risk factors associated with these functional changes. Methods Secondary analysis of data from a prospective controlled trial conducted in general medical units of an Australian tertiary teaching hospital. Participants were 615 consecutive patients aged 65 years or older admitted under a general medical unit for more than 2 days, discharged alive, and not fully dependent at pre-admission baseline. Activities of daily living measured 2 weeks before admission, at admission, and at discharge were used to calculate rates of pre-hospital and in-hospital decline and of in-hospital recovery to pre-admission function. Potential predictors including age, sex, diagnosis, illness severity, pre-admission function, pre-admission supports, and documented "geriatric syndromes" (dementia, falls, malnutrition) were investigated for each functional change outcome using multiple logistic regression models. Results Sixty-four percent of participants had pre-hospital functional decline; only 42% of these had recovered to pre-admission function by hospital discharge. Only 7% had in-hospital decline. The different functional change variables had distinct patterns of predictors. Conclusions Most decline occurred prior to hospitalization and was associated with common indicators of poor outcomes in hospitalized elders. In-hospital decline was uncommon, suggesting that in-hospital recovery may be a more appropriate intervention target.
Key findings
- Background Older medical patients often experience a decline in function associated with hospitalization.
- Objectives of this study were to separately describe pre-hospital and in-hospital functional changes in older Australian medical patients and to identify risk factors associated with these functional changes.
- Results Sixty-four percent of participants had pre-hospital functional decline; only 42% of these had recovered to pre-admission function by hospital discharge.
- Conclusions Most decline occurred prior to hospitalization and was associated with common indicators of poor outcomes in hospitalized elders.
- In-hospital decline was uncommon, suggesting that in-hospital recovery may be a more appropriate intervention target.
Study details
- Evidence strengthLow
How this study scored 36/100
Published in a peer-reviewed journal. Scored zero for study design, sample size, effect reported, studied in people and randomised / blinded because the record does not state it. We have no data on journal's citation record, times cited, citations per year, impact for its field and year, cited by studies here, still being cited, senior author's track record, institution's track record and multi-centre collaboration, so those were left out: it earned 21 of the 58 points we could judge it on, which is 36 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (The journals of gerontology. Series A, Biological sciences and medical sciences) |
| Journal's citation record | — / 4 | No journal record from OpenAlex — left out of this score |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2010 — within 20 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | — / 7 | No citation count (not found in OpenAlex) — left out of this score |
| Citations per year | — / 5 | No citation count or no year — left out of this score |
| Impact for its field and year | — / 6 | No field-weighted citation impact (OpenAlex has none yet) — left out of this score |
| Cited by studies here | — / 6 | Not yet checked against this library's citation graph — left out of this score |
| Still being cited | — / 4 | No yearly citation counts — left out of this score |
| Senior author's track record | — / 4 | Senior author's record not available — left out of this score |
| Institution's track record | — / 3 | No institution listed in OpenAlex — left out of this score |
| Multi-centre collaboration | — / 3 | Institutions not listed — left out of this score |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 20494952) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Points | 21 / 58 | Scored on 11 of 20 parts. We have no data for the rest, so they are left out: 21 of the 58 points we could judge it on is 36 out of 100. |
| Total | 36 / 100 | — |
What each of these 20 components measures, and what this score is not →
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APA 7th
Mudge, A. M., O'Rourke, P., & Denaro, C. P. (2010). Timing and risk factors for functional changes associated with medical hospitalization in older patients. The journals of gerontology. Series A, Biological sciences and medical sciences. https://doi.org/10.1093/gerona/glq069
Vancouver
Mudge AM, O'Rourke P, Denaro CP. Timing and risk factors for functional changes associated with medical hospitalization in older patients. The journals of gerontology. Series A, Biological sciences and medical sciences. 2010. doi:10.1093/gerona/glq069. PMID: 20494952.
BibTeX
@article{mudge2010-20494952,
author = {Mudge, A. M. and O'Rourke, P. and Denaro, C. P.},
title = {{Timing and risk factors for functional changes associated with medical hospitalization in older patients}},
journal = {The journals of gerontology. Series A, Biological sciences and medical sciences},
year = {2010},
doi = {10.1093/gerona/glq069},
pmid = {20494952},
url = {https://doi.org/10.1093/gerona/glq069}
}
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