Upper-extremity function prospectively predicts adverse discharge and all-cause COPD readmissions: a pilot study
| Autor: | Nima Toosizadeh, Martha Jane Mohler, Hossein Ehsani, Todd Golden |
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| Rok vydání: | 2018 |
| Předmět: |
Male
Time Factors Exacerbation Hospitalized patients early readmission Pilot Projects Pulmonary Disease Chronic Obstructive Patient Admission 0302 clinical medicine Risk Factors Longitudinal Studies Prospective Studies 030212 general & internal medicine Original Research COPD General Medicine Middle Aged adverse health outcomes Prognosis Patient Discharge Biomechanical Phenomena Frailty assessment Female Analysis of variance medicine.medical_specialty Adverse outcomes Frail Elderly frailty International Journal of Chronic Obstructive Pulmonary Disease gait Patient Readmission Risk Assessment biomechanics Decision Support Techniques Upper Extremity 03 medical and health sciences Predictive Value of Tests Internal medicine medicine Humans Geriatric Assessment Physical Examination Aged business.industry wearable sensors Discharge disposition Length of Stay medicine.disease 030228 respiratory system Feasibility Studies business All cause mortality |
| Zdroj: | International Journal of Chronic Obstructive Pulmonary Disease |
| ISSN: | 1178-2005 |
| Popis: | Hossein Ehsani,1,2 Martha Jane Mohler,1–3 Todd Golden,2 Nima Toosizadeh1–3 1Department of Biomedical Engineering, University of Arizona, Tucson, AZ, USA; 2Arizona Center on Aging, Department of Medicine, University of Arizona, Tucson, AZ, USA; 3Division of Geriatrics, General Internal Medicine and Palliative Medicine, Department of Medicine, University of Arizona, Tucson, AZ, USA Background: Frailty can inform management approaches for individuals with COPD. However, inpatient measures of frailty are seldom employed because they are time-consuming or inapplicable for bed-bound patients. We investigated the feasibility and potential of an innovative sensor-based upper-extremity function (UEF) test for frailty assessment in predicting adverse outcomes. Methods: Hospitalized patients with COPD-related exacerbations (aged ≥55 years) were recruited and performed the UEF test within 24 hours of admission. UEF parameters were obtained and fed into our previously developed frailty model to calculate frailty status (non-frail, pre-frail, and frail) and frailty score (0: extreme resilience to 1: extreme frailty). In-hospital (length of stay) and post-discharge (discharge disposition, 30-day exacerbation with treatment, and all-cause 30-day readmission) outcomes were collected. Associations between UEF frailty and outcomes were investigated using ANOVA and logistic models adjusted for demographic data. Results: In total, 42 patients were recruited. All participants were able to perform the UEF test. Based on UEF, participants were stratified into three groups of non-frail (n=6, frailty score =0.18±0.09), pre-frail (n=14, frailty score =0.45±0.09), and frail (n=22, frailty score =0.78±0.11). Both frailty status and frailty score were significantly associated with unfavorable discharge disposition (P0.5) nor 30-day exacerbation with treatment (P>0.70). Age was only significantly associated with unfavorable discharge disposition (P=0.048). Conclusion: In agreement with previous work, the current findings underline the importance of measuring frailty for risk-stratification of COPD patients. The UEF was feasible and easily performed among all hospitalized COPD patients. In this study, we have shown that, using our quick and objective frailty measures, COPD patients can be prospectively risk-stratified in terms of unfavorable discharge disposition and all-cause 30-day readmissions. Keywords: COPD, frailty, adverse health outcomes, early readmission, biomechanics, gait, wearable sensors |
| Databáze: | OpenAIRE |
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