Background
Methods
Study cohort
Clinical and functional characteristics of patients
Clinical characteristics
Functional characteristics: ISAR screening
Functional characteristics: CGA
In-hospital medical needs
Statistical analyses
Results
Study cohort
Total cohort (n = 242) | Length of hospital stay | Nursing hours per days | Received physiotherapy | ||||
---|---|---|---|---|---|---|---|
< 7 days n = 100, 41.3% | ≥7 days n = 142, 58.7% | < 2 h n = 104, 49.1% | ≥2 h n = 108, 50.9% | No n = 159, 65.7% | Yes n = 83, 34.3% | ||
Age (years), mean ± SD | 78.41 ± 6.4 | 79.0 ± 5.9 | 78.04 ± 6.7 | 77.44 ± 6.0 | 78.87 ± 6.5 | 78. 13 ± 6.0 | 78.95 ± 7.0 |
Sex (male), n(%) | 139 (57.2) | 65 (65.0)* | 74 (52.1) | 67 (64.4) | 56 (51.9) | 100 (62.9)* | 44 (53.0) |
Number of admission diagnoses, (median[Q1;Q3]) | 1.0 [1.0;3.25] | 1.0 [1.0;2.0 † | 2.0 [2.0;6.0] | 1.0 [1.0;6.0] | 2.0 [1.0;3.0] | 1.0 [1.0;2.0]† | 3.0 [1.0;7.0] |
ISAR (score), (median[Q1;Q3]) | 2.0 [2.0;4.0] | 2.0 [2.0;3.0] | 3.0 [2.0;4.0] | 2.0 [2.0;3.0]* | 3.0 [2.0;4.0] | 2.0 [2.0;3.0]* | 3.0 [2.0;4.0] |
ADL impairment, n(%) | 114 (47.1) | 35 (35.0)* | 79 (55.6) | 35 (33.7)† | 66 (61.1) | 51 (32.1)† | 63 (75.9) |
Mobility impairment, n(%) | 85 (35.1) | 26 (26.0)* | 59 (41.5) | 31 (29.8)* | 46 (42.6) | 47 (29.6)* | 38 (45.8) |
Cognition impairment, n(%) | 130 (53.7) | 47 (47.0) | 83 (58.5) | 50 (48.1) | 65 (60.2) | 75 (47.2)* | 55 (66.3) |
Signs of depression, n(%) | 28 (11.6) | 6 (6.0)* | 22 (15.5) | 12 (11.5) | 13 (12.0) | 11 (6.9)* | 17 (20.5) |
Length of hospital stay (days), (median[Q1;Q3]) | 9.0 (4.0;16.0) | 3.5 (3.0;5.0)† | 14.0 (10.0;24.3) | 8.0 (4.0;13.8) | 11.0 (3.0;21.0) | 6.0 (3.0;11.0)† | 20.0 (11.0;30.0) |
Nursing hours per day (hours/day), (median[Q1;Q3]) | 2.01 (1.5;2.7) | 1.9 (1.4;2.6)† | 2.1 (1.6;2.9) | 1.5 (1.3;1.8)† | 2.7 (2.3;3.3) | 1.8 (1.4;2.5)* | 2.6 (1.9;3.3) |
Received physiotherapy, n(%) | 83 (34.3) | 7 (7.0)† | 76 (53.5) | 25 (24.0)* | 48 (44.4) | 0.0 (0.0)† | 83 (100.0) |
Arterial hypertension, n(%) | 193 (79.8) | 77 (77.0) | 116 (81.7) | 85 (81.7) | 88 (81.5) | 124 (78.0) | 69 (83.1) |
Hyperlipoproteinemia, n(%) | 134 (55.4) | 51 (51.0) | 83 (58.5) | 63 (60.6) | 59 (54.6) | 89 (56.0) | 45 (54.2) |
Diabetes | 78 (32.2) | 35 (35.0) | 43 (30.3) | 34 (32.7) | 36 (33.3) | 54 (34.0) | 24 (28.9) |
History of stroke | 31 (12.8) | 11 (11.0) | 20 (14.1) | 9 (8.7) | 15 (13.9) | 16 (10.1) | 15 (18.1) |
Dementia, n(%) | 25 (10.3) | 9 (9.0) | 16 (11.3) | 4 (3.8)* | 14 (13.0) | 14 (8.8) | 11 (13.3) |
History of myocardial infarction | 22 (9.1) | 9 (9.0) | 13 (9.2) | 10 (9.6) | 7 (6.5) | 13 (8.2) | 9 (10.8) |
Coronary heart disease | 96 (39.7) | 33 (33.0) | 63 (44.4) | 50 (48.1) | 40 (37.0) | 63 (39.6) | 33 (39.8) |
Valve insufficiency | 92 (38.0) | 33 (33.0) | 59 (41.5) | 40 (38.5) | 39 (36.1) | 57 (35.8) | 35 (42.2) |
Chronic obstructive pulmonary disease | 32 (13.2) | 12 (12.0) | 20 (14.1) | 18 (17.3) | 10 (9.3) | 17 (10.7) | 15 (18.1) |
Peripheral artery disease | 43 (17.8) | 14 (14.0) | 29 (20.4) | 23 (22.1) | 16 (14.8) | 29 (18.2) | 14 (16.9) |
Chronic kidney disease, n(%) | 118 (48.8) | 46 (46.0) | 72 (50.7) | 53 (51.0) | 49 (45.4) | 81 (50.9) | 37 (44.6) |
Cancer, n(%) | 94 (38.8) | 50 (50.0)* | 44 (31.0) | 46 (44.2) | 34 (31.5) | 73 (45.9)* | 21 (25.3) |
Depression, n(%) | 12 (5.0) | 5 (5.0) | 7 (4.9) | 1 (1.0)* | 10 (9.3) | 8 (5.0) | 4 (4.8) |
Factors associated with needs for intensified medical care
Length of hospital stay
Unadjusted | Model 1 Corrected R2 = 0.038 | Model 2 Corrected R2 = 0.147 | |||||||
β or B | 95% CI | P | β or B | 95% CI | P | β or B | 95% CI | P | |
Age (years) | − 0.19 | − 0.66;-0.13 | 0.004* | − 0.22 | − 0.34;-0.09 | 0.001† | − 0.27 | − 0.39;0.14 | < 0.001† |
Sex (male vs female) | 1.203 | −2.28;4.69 | 0.497 | 1.82 | − 1.62;5.23 | 0.299 | 0.26 | −3.05;3.52 | 0.876 |
Number of admission diagnoses | 0.28 | 0.16;0.41 | < 0.001† | ||||||
ISAR score | 0.06 | −0.26;0.72 | 0.363 | 0.104 | − 0.02;0.23 | 0.108 | |||
ADL impairment (yes vs no) | 6.66 | 3.31;10.01 | < 0.001† | 8.03 | 4.43;11.88 | < 0.001† | |||
Mobility impairment (yes vs no) | 1.47 | −2.11;5.05 | 0.481 | −2.08 | −6.21;1.66 | 0.311 | |||
Cognition impairment (yes vs no) | 3.35 | −0.07;6.78 | 0.055 | 3.77 | 0.50;7.05 | 0.024* | |||
Signs of depression (yes vs no) | 6.69 | 1.43;11.94 | 0.013* | 6.43 | 1.19;11.67 | 0.016* | |||
Model 3 Corrected R2 = 0.143 | Model 4 Corrected R2 = 0.197 | ||||||||
β or B | 95% CI | P | β or B | 95% CI | P | ||||
Age (years) | −0.27 | −0.40;-0.14 | < 0.001† | − 0.26 | − 0.38;-0.14 | < 0.001† | |||
Sex (male vs female) | 0.25 | −3.05;3.56 | 0.880 | 0.04 | −3.19;3.21 | 0.982 | |||
Number of admission diagnoses | 0.24 | 0.12;0.36 | < 0.001† | ||||||
ISAR score | 0.00 | −0.13;0.13 | 0.966 | 0.00 | −0.12;0.13 | 0.957 | |||
ADL impairment (yes vs no) | 8.05 | 4.19;11.91 | < 0.001† | 7.38 | 3.72;11.26 | < 0.001† | |||
Mobility impairment (yes vs no) | −2.03 | −5.97;1.91 | 0.312 | −2.44 | −6.46;1.19 | 0.210 | |||
Cognition impairment (yes vs no) | 3.78 | 0.48;7.08 | 0.025* | 3.72 | 0.50;6.89 | 0.023* | |||
Signs of depression (yes vs no) | 6.43 | 1.18;11.69 | 0.017* | 5.85 | 0.78;10.95 | 0.025* |
Nursing hours per day
Unadjusted | Model 1 Corrected R2 = 0.022 | Model 2 Corrected R2 = 0.051 | |||||||
β or B | 95% CI | P | β or B | 95% CI | P | β or B | 95% CI | P | |
Age (years) | 0.09 | −0.05;0.23 | 0.196 | 0.05 | −0.09;0.19 | 0.493 | 0.49 | −1.95;0.22 | 0.578 |
Sex (male vs female) | 0.42 | −0.08;0.92 | 0.102 | 0.39 | −0.11;0.89 | 0.121 | 0.19 | −0.25;0.71 | 0.532 |
Number of admission diagnoses | 0.03 | −0.11;0.16 | 0.693 | ||||||
ISAR score | 0.26 | 0.01;0.28 | 0.032* | 0.135 | −0.01;0.27 | 0.056 | |||
ADL impairment (yes vs no) | 1.14 | 0.67;1.61 | < 0.001† | 1.01 | 0.95;2.09 | 0.008* | |||
Mobility impairment (yes vs no) | 0.31 | −0.34;0.96 | 0.345 | −0.35 | −1.59;-0.38 | 0.393 | |||
Cognition impairment (yes vs no) | 0.57 | 0.07;1.07 | 0.026* | 0.38 | −0.09;0.88 | 0.212 | |||
Signs of depression (yes vs no) | 0.40 | −0.37;1.17 | 0.311 | −0.19 | −0.50;1.04 | 0.727 | |||
Model 3 Corrected R2 = 0.046 | Model 4 Corrected R2 = 0.039 | ||||||||
β or B | 95% CI | P | β or B | 95% CI | P | ||||
Age (years) | 0.03 | −0.12;0.21 | 0.519 | 0.05 | −0.12;0.21 | 0.597 | |||
Sex (male vs female) | 0.24 | −0.41;0.82 | 0.513 | 0.21 | −0.41;0.82 | 0.513 | |||
Number of admission diagnoses | −0.06 | − 0.17;0.16 | 0.954 | ||||||
ISAR score | 0.05 | −0.13;0.21 | 0.669 | 0.04 | −0.13;0.21 | 0.669 | |||
ADL impairment (yes vs no) | 1.03 | 0.25;1.82 | 0.011* | 1.03 | 0.24;1.83 | 0.011* | |||
Mobility impairment (yes vs no) | −0.36 | −1.59;-0.38 | 0.378 | −0.36 | −1.27;-0.45 | 0.379 | |||
Cognition impairment (yes vs no) | 0.36 | −0.26;0.96 | 0.252 | 0.36 | −0.26;0.97 | 0.253 | |||
Signs of depression (yes vs no) | −0.19 | −1.27;0.89 | 0.725 | −0.19 | −1.28;0.90 | 0.732 |
Receiving physiotherapy
Unadjusted | Model 1 Corrected R2 = 0.050 | Model 2 Corrected R2 = 0.291 | |||||||
RR | 95% CI | P | RR | 95% CI | P | RR | 95% CI | P | |
Age (years) | 1.01 | 0.99;1.04 | 0.357 | 1.01 | 0.98;1.03 | 0.751 | 0.97 | 0.93;1.02 | 0.206 |
Sex (male vs female) | 1.52 | 1.08;2.16 | 0.018* | 1.52 | 1.07;2.14 | 0.018* | 1.02 | 0.59;1.61 | 0.933 |
Number of admission diagnoses | 1.06 | 1.04;1.08 | < 0.001† | ||||||
ISAR score | 1.17 | 1.00;1.36 | 0.050 | 1.16 | 0.99;1.35 | 0.053 | |||
ADL impairment (yes vs no) | 3.54 | 2.29;5.47 | < 0.001† | 3.16 | 1.76;5.67 | < 0.001† | |||
Mobility impairment (yes vs no) | 1.44 | 0.84;2.46 | 0.186 | 0.69 | 0.39;1.22 | 0.206 | |||
Cognition impairment (yes vs no) | 1.77 | 1.20;2.62 | 0.004* | 1.69 | 0.96;2.97 | 0.070 | |||
Signs of depression (yes vs no) | 1.99 | 1.39;2.85 | < 0.001 | 1.86 | 1.03;3.37 | 0.039* | |||
Model 3 Corrected R2 = 0.291 | Model 4 Corrected R2 = 0.336 | ||||||||
RR | 95% CI | P | RR | 95% CI | P | ||||
Age (years) | 0.97 | 0.93;1.02 | 0.203 | 0.98 | 0.93;1.02 | 0.288 | |||
Sex (male vs female) | 1.04 | 0.62;1.74 | 0.896 | 1.05 | 0.62;1.77 | 0.854 | |||
Number of admission diagnoses | 1.06 | 1.02;1.09 | 0.001 | ||||||
ISAR score | 1.04 | 0.79;1.37 | 0.791 | 1.02 | 0.76;1.36 | 0.914 | |||
ADL impairment (yes vs no) | 3.12 | 1.71;5.67 | < 0.001† | 2.86 | 1.57;5.20 | 0.001† | |||
Mobility impairment (yes vs no) | 0.69 | 0.39;1.22 | 0.198 | 0.75 | 0.42;1.32 | 0.315 | |||
Cognition impairment (yes vs no) | 1.67 | 0.94;2.96 | 0.080 | 1.75 | 1.00;3.05 | 0.050 | |||
Signs of depression (yes vs no) | 1.85 | 1.03;3.33 | 0.039* | 1.75 | 0.96;3.20 | 0.070 |