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The impact of functional status on LOS and readmission in older patients in geriatrics department: a cohort study

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Abstract

Background

Length of hospital stay (LOS) and readmission are important outcomes for older inpatients. The association between functional status on admission and outcomes has not been well investigated in Chinese elderly.

Objectives

To detect the impact of function impairments on LOS and 90-day readmission in a population of Chinese elderly inpatients.

Methods

This is a prospective cohort study. All new patients over 60 years in geriatrics department of a university hospital in Western China from June to August 2016 were enrolled. Activities of daily living (ADL) and Instrumental ADL (IADL) on admission were evaluated with Barthel Index and Lawton IADL. Outcomes were LOS and 90-day readmission. LOS was calculated as the total days of hospital stay. Readmission was investigated through telephone interviews after discharge. Pearson Chi-square test was used to detect the associations. Binary logistic regression was used to detect the association of function status on admission with LOS and readmission.

Results

A total of 225 patients were enrolled. Mean age 82.41 (± 7.316; 63–99), 31.1% were females. Overall, 64.9% of the patients were hospitalized longer than 14 days and 33.30% experienced a 90-day readmission. Following an adjustment for age, gender, marital status, education level, smoking, alcohol, nutrition status, and admission location, the binary logistic regression models showed that both ADL impairment (OR 2.03; 95% CI 1.06–3.87) and IADL impairment (OR 2.54; 95% CI 1.28–5.01) were independent predictors for LOS. ADL impairment was an independent predictor for 90-day readmission (OR 2.26; 95% CI 1.14–4.47), while IADL impairment was not associated with readmission (OR 1.43; 95% CI 0.68–3.02).

Conclusion

Functional status on admission is the predictor of LOS and 90-day readmission in Chinese older inpatients from the geriatric department of a university hospital.

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Funding

This research was supported by a Grant from the Sichuan Science and Technology Agency of China (Grant no. 2017FZ0096).

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Authors and Affiliations

  1. The Center of Gerontology and Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, No. 37, Guoxuexiang, Chengdu, 610041, Sichuan, China

    Yanjiao Shen, Qiukui Hao, Shuang Liu, Lin Su, Xuelian Sun, Birong Dong & Li Cao

  2. Geriatrics, Envision Physician Health Services, and Adjunct in Division of Geriatrics, University of Texas Southwestern, 13737 Noel Rd Suite 1600, Dallas, TX, 75240, United States

    Joseph H. Flaherty

Authors
  1. Yanjiao Shen
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  2. Qiukui Hao
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  3. Shuang Liu
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  4. Lin Su
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  5. Xuelian Sun
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  6. Joseph H. Flaherty
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  7. Birong Dong
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  8. Li Cao
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Correspondence to Li Cao.

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Conflict of interest

None of the authors have any conflicts of interest and have no relation to the funding organization.

Ethics approval

Ethical approval for the study was received from the Human Research Ethics Committees of the participating institutions and complied with the Declaration of Helsinki rules for human experimentation. The study protocol was approved by the Research Ethics Committee of Sichuan University.

Conflict of interest

The research assistant got orally consented from each participant before the data collection.

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Shen, Y., Hao, Q., Liu, S. et al. The impact of functional status on LOS and readmission in older patients in geriatrics department: a cohort study. Aging Clin Exp Res 32, 1977–1983 (2020). https://doi.org/10.1007/s40520-019-01411-3

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  • DOI: https://doi.org/10.1007/s40520-019-01411-3

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