ArticleJournal of the American Geriatrics Society2011
A clinical index to stratify hospitalized older adults according to risk for new-onset disability.
Article in Journal of the American Geriatrics Society, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 2 of them syntheses that pooled it.
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Who cites it
35 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Predicting the need for supportive services after discharged from hospital: a systematic review.BMC health services research · 2020Pooled it
- Guiding principles for the care of older adults with multimorbidity: an approach for clinicians: American Geriatrics Society Expert Panel on the Care of Older Adults with Multimorbidity.Journal of the American Geriatrics Society · 2012Guideline
- Days Alive and Out of Hospital: Exploring a Patient-Centered, Pragmatic Outcome in a Clinical Trial of Patients With Acute Coronary Syndromes.Circulation. Cardiovascular quality and outcomes · 2018Trial
- Mobility surveillance as a public health blind spot in long-term care.Frontiers in public health · 2026Article
- Mortality Outcomes and Contributing Risk Factors in Patients with Hospital-Associated Disability.Journal of clinical medicine · 2024Article
- Influence of Knee Osteoarthritis Severity, Knee Pain, and Depression on Physical Function: A Cross-Sectional Study.Clinical interventions in aging · 2024Article
- Development and applicability of a risk assessment tool for hospital-acquired mobility impairment in ambulatory older adults.Journal of the American Geriatrics Society · 2023Article
- Development and validation of prediction models for the discharge destination of elderly patients with aspiration pneumonia.PloS one · 2023Article
- Albumin and C-reactive protein relate to functional and body composition parameters in patients admitted to geriatric rehabilitation after acute hospitalization: findings from the RESORT cohort.European geriatric medicine · 2022Article
- Effect of a weekly functional independence measure scale on the recovery of patient with acute stroke: A retrospective study.Medicine · 2022Article
- Functional decline in hospitalized older patients with coronavirus disease 2019: a retrospective cohort study.BMC geriatrics · 2021Article
- Multidimensional risk score to stratify community-dwelling older adults by future fall risk using the Stopping Elderly Accidents, Deaths and Injuries (STEADI) framework.Injury prevention : journal of the International Society for Child and Adolescent Injury Prevention · 2021Article
- Self-Care Index and Post-Acute Care Discharge Score to Predict Discharge Destination of Adult Medical Inpatients: Protocol for a Multicenter Validation Study.JMIR research protocols · 2021Article
- Using best subset regression to identify clinical characteristics and biomarkers associated with sepsis-associated acute kidney injury.American journal of physiology. Renal physiology · 2020Article
- Predicting hospitalisation-associated functional decline in older patients admitted to a cardiac care unit with cardiovascular disease: a prospective cohort study.BMC geriatrics · 2020Article
- ADL recovery trajectory after discharge and its predictors among baseline-independent older inpatients.BMC geriatrics · 2020Article
- Effects of depression, dementia and delirium on activities of daily living in elderly patients after discharge.BMC geriatrics · 2019Observational
- Factors associated with prolonged length of stay in patients admitted with severe hypoglycaemia to a tertiary care hospital.Endocrinology, diabetes & metabolism · 2019Article
- The Acute Care for Elders Unit Model of Care.Geriatrics (Basel, Switzerland) · 2018Article
- Functional deterioration in the month before hospitalisation is associated with in-hospital functional decline: an observational study.European geriatric medicine · 2018Article
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Authors and funding
9 authors.
Funding
Abstract
backgroundMany older adults who are independent prior to hospitalization develop a new disability by hospital discharge. Early risk stratification for new-onset disability may improve care. Thus, this study's objective was to develop and validate a clinical index to determine, at admission, risk for new-onset disability among older, hospitalized adults at discharge.
designData analyses derived from two prospective studies.
settingTwo teaching hospitals in Ohio.
participantsEight hundred eighty-five patients aged 70 years and older were discharged from a general medical service at a tertiary care hospital (mean age 78, 59% female) and 753 patients discharged from a separate community teaching hospital (mean age 79, 63% female). All participants reported being independent in five activities of daily living (ADLs: bathing, dressing, transferring, toileting, and eating) 2 weeks before admission. MEASUREMENTS: New-onset disability, defined as a new need for personal assistance in one or more ADLs at discharge in participants who were independent 2 weeks before hospital admission.
resultsSeven independent risk factors known on admission were identified and weighted using logistic regression: age (80-89, 1 point; ≥90, 2 points); dependence in three or more instrumental ADLs at baseline (2 points); impaired mobility at baseline (unable to run, 1 point; unable to climb stairs, 2 points); dependence in ADLs at admission (2-3 ADLs, 1 point; 4-5 ADLs, 3 points); acute stroke or metastatic cancer (2 points); severe cognitive impairment (1 point); and albumin less than 3.0 g/dL (2 points). New-onset disability occurred in 6%, 13%, 18%, 34%, 35%, 45%, 50%, and 87% of participants with 0, 1, 2, 3, 4, 5, 6, and 7 or more points, respectively, in the derivation cohort (area under the receiver operating characteristic curve (AUC)=0.784), and in 8%, 10%, 27%, 38%, 44%, 45%, 58%, and 83%, respectively, in the validation cohort (AUC=0.784). The risk score also predicted (P<.001) disability severity, nursing home placement, and long-term survival.
conclusionThis clinical index determines risk for new-onset disability in hospitalized older adults and may inform clinical care.
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