Background. Physical function measurements can predict health outcomes, such as mortality, in community-dwelling older persons. Few studies have examined the predictive value of physical performance measurements in acute hospital setting. In this study, we identified hospital outcome predictors in older in-patients by using a multi-component approach including physical performance measurements.
Methods. Data are from the CRiteria to assess appropriate Medication use among Elderly complex patients (CRIME) project. This was a multicentre, observational study of 1123 older patients, consecutively admitted to geriatric and internal medicine acute care wards of seven Italian hospitals. Data on demographics, anthropometrics, social factors, cognitive status (Mini Mental State Examination), psychological status (15 items Geriatric Depression Scale), medical diagnoses, geriatric conditions, and physical function (walking speed, grip strength, ADL) were recorded. Hospital outcomes were length of stay, in-hospital mortality, and institutionalization.
Results. Mean age of participants was 81 years, 56% were women. Median LoS was 10 (7-14) days, 41 patients died during hospital stay and 37 were newly institutionalized. Number of drugs before admission, metastasized cancer, renal failure or dialysis, infection, falls at home during the last year, pain, and walking speed were independent predictors of LoS. Inability to perform grip strength and total ADL dependency were independent predictors of in-hospital mortality. Malnutrition and total ADL dependency were independent predictors of institutionalization.
Conclusions. Our findings demonstrate that the assessment of physical function is important to identify patients at risk of poor hospital outcome
