Inpatient Walking Activity to Predict Readmission in Older Adults.

Inpatient Walking Activity to Predict Readmission in Older Adults.

The aim of this study was to compare the 30-day readmission predictive power of in-hospital walking activity and in-hospital activities of daily living (ADLs) in older acutely ill patients. In addition, the team sought to identify preliminary walking thresholds that could support the targeting of interventions aimed at minimizing rehospitalizations. One hundred sixty-four ambulatory persons aged 65 years and older admitted to the hospital from the community with an acute medical illness. Readmission back to the index hospital (yes vs no) within 30 days of discharge was the main outcome meaure used. Twenty-six patients (15.8%) were readmitted within 30 days of discharge. Walking activity during hospitalization was more strongly and significantly associated with 30-day readmission (odds ratio=0.90; 95% confidence interval, 0.82-0.98) than ADL function (odds ratio=0.45; 95% confidence interval, 0.14-1.45) after adjusting for relevant readmission risk factors. The predictive accuracy (area under the curve) was highest for models that included walking activity and changed little with the addition of ADLs. A walking threshold of 275 steps or more per day identified patients at reduced 30-day readmission risk.

Walking activity was a stronger predictor of readmission than ADLs. Monitoring patient activity during hospitalization may provide clinicians with valuable information on early readmission risk not captured by measures of ADLs. Further study is needed to replicate these findings and monitor walking activity posthospitalization to further advance our understanding of readmission risk.

Scott BuxtonResearch article posted by: Scott Buxton

My name is Scott and I am currently the editor of physiospot.

Away from the keyboard I am extended scope physiotherapist working in ED and an acute frailty unit specialising in rapid assessment and discharge of acutely unwell frail older people.

Comments

  1. Derek Laidler says:

    The idea that simultaneously assessing proprioception, balance and muscle power in a complex functional task is somehow beneath a Physiotherapist has always annoyed me. It only seems to come from those who have no interest in any form of care for elderly patients. The fact that studies show that NHS patients who require any form help walking typically spend less than 1% of their time on their feet tells you a lot about why we have such high readmission rates and as Physiotherapists we should be educating commissioners about the importance of functional exercises in an inpatient setting

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