Predictors for a good recovery after subacute geriatric care

J. Foss Abrahamsen 1 , S. Boffelli 2 , R. Rozzini 3 , A. Cassinadri 2 , A.H. Ranhoff 1 , M. Trabucchi 4

1  Kavli Research Centre for Geriatrics and Dementia, Haraldsplass Deaconess Hospital, Bergen, Norway; 2   Sub Acute Care Unit, Fondazione Ospedale Poliambulanza, Brescia and Italian Research Group, Brescia, Italy; 3   Geriatric Department, Fondazione Ospedale Poliambulanza, Brescia and Italian Research Group, Brescia, Italy; 4  Department of Neuropsycopharmacology, University of Rome II, and Geriatric Research Group

Background and aims. We wanted to investigate eight different geriatric assessment tests regarding the prediction of 1) a good recovery (ability to return to own home or transfer to further rehabilitation), and 2) a poor recovery (discharge to nursing home, hospice, acute hospitals or death) in elderly patients treated in a subacute geriatric hospital ward.

Methods. Consecutive 664 community-dwelling patients aged ≥ 70 years, transferred from acute medical and geriatric wards to a subacute geriatric ward were included. Demographic data and eight different geriatric assessment tests were recorded, and odds ratio for having a good versus poor recovery was assessed with logistic regression analysis.

Results. Improvement in Barthel index (OR = 6.77, 95% CI 3.41-13.45, p < 0.001) and the Tinetti scale (OR 4.58, 95% CI 2.36-8.89, p < 0.001), along with the absence of symptoms of depression (OR = 2.19, 95% CI 1.04-4.59, p = 0.04) and cognitive impairment (OR = 2.19, 95%CI 1.10-4.30, p = 0.02), were significantly associated with a good versus bad recovery in logistic multivariate regression analysis. Significant collinearity (R > 0.75, p < 0.001) was demonstrated between several of the functional assessment tests.

Conclusions. Functional assessments with Barthel index at admission to the subacute ward and one day before discharge, as well as evaluation with MMSE and GDS once during the stay in the subacute ward, gave the optimal prediction of short term recovery. Further assessment with other overlapping functional tests may be redundant.

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