Functional mobility trajectories of hospitalized older adults admitted to acute geriatric wards: A retrospective observational study in an English university hospital.
Geriatrics & gerontology international
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Lyons, A., Romero-Ortuno, R., & Hartley, P. (2019). Functional mobility trajectories of hospitalized older adults admitted to acute geriatric wards: A retrospective observational study in an English university hospital.. Geriatrics & gerontology international, 19 (4), 305-310. https://doi.org/10.1111/ggi.13623
Abstract Aim: the mobility trajectories of hospitalized older people are heterogeneous and there is a need to understand patient groups with similar trajectories. Our aims were to identify mobility trajectories of older patients admitted to geriatric wards in an English university hospital, and describe patient characteristics and outcomes associated with different mobility groups. Methods: retrospective observational study of first admissions to geriatric wards for three months starting 1st May 2016. Anonymized routinely collected clinical data was extracted from the electronic patient records: age, sex, Clinical Frailty Scale score, presence of delirium (yes/no), diagnosis of dementia (yes/no), Charlson Comorbidity Index, falls in the last year and the highest recorded Modified Early Warning Score in the Emergency Department. Physiotherapists routinely collected the Elderly Mobility Scale on admission and discharge; this information was entered in a K-means cluster analysis to identify mobility trajectory groups. We compared clinical characteristics and outcomes between these groups and used logistic regression models to determine independent predictors of group membership. Results: the overall functional trajectory was improvement, from a median Elderly Mobility Scale of 11 on admission to 14 on discharge. Cluster analysis identified 5 mobility trajectory groups: Low-Low (n=117), Intermediate-Intermediate (n=95), Intermediate-High (n=205), Low-High (n=89), and High-High (n=209). Higher frailty and the presence of cognitive impairment were associated with the Low-Low and Intermediate-Intermediate group membership, and negatively associated with the High-High group membership. Conclusions: the majority of hospitalized patients experienced functional improvement. Frailty and cognitive impairment may be associated with poorer mobility trajectories and hence require early identification.
Humans, Hospitalization, Geriatric Assessment, Risk Assessment, Risk Factors, Aged, Emergency Service, Hospital, Female, Male, Mobility Limitation, United Kingdom, Cognitive Dysfunction, Frailty, Physical Functional Performance
External DOI: https://doi.org/10.1111/ggi.13623
This record's URL: https://www.repository.cam.ac.uk/handle/1810/288688