Mobility after hospital discharge as a marker for 30-day readmission

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Abstract

Background. Little is known about older patient's mobility soon after discharge home from an acute hospitalization. We examined daily postdischarge mobility levels as marker of overall health and response to in-hospital treatment in older medicine patients.Methods. One hundred and eleven ambulatory men and women aged 65 years and older hospitalized with an acute medical illness and discharged to home were studied. Patients received an ankle-worn accelerometer during hospitalization and wore it continually for up to 1 week after discharge. Total number of steps taken per day was assessed. The primary outcome was all-cause 30-day readmission.Results. Thirteen (11.7%) participants were readmitted within 30 days of discharge. There was a significant association between mean daily steps taken postdischarge and 30-day readmission (odds ratio = 0.85, 95% confidence interval = 0.72-0.99, and p =. 04; odds ratio and confidence intervals were calculated for 500-step intervals). Though not statistically significant in the fully adjusted model (odds ratio = 0.83, 95% confidence interval = 0.71-1.02, and p =. 08), mean daily steps was the strongest predictor among known readmission risk factors. The least active participants postdischarge were significantly more likely to be older (p =. 02), be not married (p =. 02), use a cane or walker prior to admission (p <. 01), have longer lengths of hospital stay (p =. 02), and be readmitted (p =. 05).Conclusions. Mobility level soon after discharge home shows promise as a simple physical biomarker of overall health and risk of 30-day readmission in older patients.

Original languageEnglish (US)
Pages (from-to)805-810
Number of pages6
JournalJournals of Gerontology - Series A Biological Sciences and Medical Sciences
Volume68
Issue number7
DOIs
StatePublished - Jul 2013

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Odds Ratio
Confidence Intervals
Length of Stay
Hospitalization
Canes
Health
Ankle
Biomarkers
Medicine
Therapeutics

Keywords

  • 30-day readmission
  • Mobility.
  • Older adult

ASJC Scopus subject areas

  • Aging
  • Geriatrics and Gerontology
  • Medicine(all)

Cite this

@article{e3c2f905ea6a4bf6b4f30045682c35f3,
title = "Mobility after hospital discharge as a marker for 30-day readmission",
abstract = "Background. Little is known about older patient's mobility soon after discharge home from an acute hospitalization. We examined daily postdischarge mobility levels as marker of overall health and response to in-hospital treatment in older medicine patients.Methods. One hundred and eleven ambulatory men and women aged 65 years and older hospitalized with an acute medical illness and discharged to home were studied. Patients received an ankle-worn accelerometer during hospitalization and wore it continually for up to 1 week after discharge. Total number of steps taken per day was assessed. The primary outcome was all-cause 30-day readmission.Results. Thirteen (11.7{\%}) participants were readmitted within 30 days of discharge. There was a significant association between mean daily steps taken postdischarge and 30-day readmission (odds ratio = 0.85, 95{\%} confidence interval = 0.72-0.99, and p =. 04; odds ratio and confidence intervals were calculated for 500-step intervals). Though not statistically significant in the fully adjusted model (odds ratio = 0.83, 95{\%} confidence interval = 0.71-1.02, and p =. 08), mean daily steps was the strongest predictor among known readmission risk factors. The least active participants postdischarge were significantly more likely to be older (p =. 02), be not married (p =. 02), use a cane or walker prior to admission (p <. 01), have longer lengths of hospital stay (p =. 02), and be readmitted (p =. 05).Conclusions. Mobility level soon after discharge home shows promise as a simple physical biomarker of overall health and risk of 30-day readmission in older patients.",
keywords = "30-day readmission, Mobility., Older adult",
author = "Steven Fisher and Kuo, {Yong Fang} and Gulshan Sharma and Mukaila Raji and Amit Kumar and James Goodwin and Ostir, {Glenn V.} and Kenneth Ottenbacher",
year = "2013",
month = "7",
doi = "10.1093/gerona/gls252",
language = "English (US)",
volume = "68",
pages = "805--810",
journal = "Journals of Gerontology - Series A Biological Sciences and Medical Sciences",
issn = "1079-5006",
publisher = "Oxford University Press",
number = "7",

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T1 - Mobility after hospital discharge as a marker for 30-day readmission

AU - Fisher, Steven

AU - Kuo, Yong Fang

AU - Sharma, Gulshan

AU - Raji, Mukaila

AU - Kumar, Amit

AU - Goodwin, James

AU - Ostir, Glenn V.

AU - Ottenbacher, Kenneth

PY - 2013/7

Y1 - 2013/7

N2 - Background. Little is known about older patient's mobility soon after discharge home from an acute hospitalization. We examined daily postdischarge mobility levels as marker of overall health and response to in-hospital treatment in older medicine patients.Methods. One hundred and eleven ambulatory men and women aged 65 years and older hospitalized with an acute medical illness and discharged to home were studied. Patients received an ankle-worn accelerometer during hospitalization and wore it continually for up to 1 week after discharge. Total number of steps taken per day was assessed. The primary outcome was all-cause 30-day readmission.Results. Thirteen (11.7%) participants were readmitted within 30 days of discharge. There was a significant association between mean daily steps taken postdischarge and 30-day readmission (odds ratio = 0.85, 95% confidence interval = 0.72-0.99, and p =. 04; odds ratio and confidence intervals were calculated for 500-step intervals). Though not statistically significant in the fully adjusted model (odds ratio = 0.83, 95% confidence interval = 0.71-1.02, and p =. 08), mean daily steps was the strongest predictor among known readmission risk factors. The least active participants postdischarge were significantly more likely to be older (p =. 02), be not married (p =. 02), use a cane or walker prior to admission (p <. 01), have longer lengths of hospital stay (p =. 02), and be readmitted (p =. 05).Conclusions. Mobility level soon after discharge home shows promise as a simple physical biomarker of overall health and risk of 30-day readmission in older patients.

AB - Background. Little is known about older patient's mobility soon after discharge home from an acute hospitalization. We examined daily postdischarge mobility levels as marker of overall health and response to in-hospital treatment in older medicine patients.Methods. One hundred and eleven ambulatory men and women aged 65 years and older hospitalized with an acute medical illness and discharged to home were studied. Patients received an ankle-worn accelerometer during hospitalization and wore it continually for up to 1 week after discharge. Total number of steps taken per day was assessed. The primary outcome was all-cause 30-day readmission.Results. Thirteen (11.7%) participants were readmitted within 30 days of discharge. There was a significant association between mean daily steps taken postdischarge and 30-day readmission (odds ratio = 0.85, 95% confidence interval = 0.72-0.99, and p =. 04; odds ratio and confidence intervals were calculated for 500-step intervals). Though not statistically significant in the fully adjusted model (odds ratio = 0.83, 95% confidence interval = 0.71-1.02, and p =. 08), mean daily steps was the strongest predictor among known readmission risk factors. The least active participants postdischarge were significantly more likely to be older (p =. 02), be not married (p =. 02), use a cane or walker prior to admission (p <. 01), have longer lengths of hospital stay (p =. 02), and be readmitted (p =. 05).Conclusions. Mobility level soon after discharge home shows promise as a simple physical biomarker of overall health and risk of 30-day readmission in older patients.

KW - 30-day readmission

KW - Mobility.

KW - Older adult

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U2 - 10.1093/gerona/gls252

DO - 10.1093/gerona/gls252

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JF - Journals of Gerontology - Series A Biological Sciences and Medical Sciences

SN - 1079-5006

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