Fallers in postacute rehabilitation have worse functional recovery and increased health services use.

Details

Serval ID
serval:BIB_CEA9FD8C1EDE
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Fallers in postacute rehabilitation have worse functional recovery and increased health services use.
Journal
Journal of the American Medical Directors Association
Author(s)
Rochat S., Monod S., Seematter-Bagnoud L., Lenoble-Hoskovec C., Büla C.J.
ISSN
1538-9375 (Electronic)
ISSN-L
1525-8610
Publication state
Published
Issued date
2013
Volume
14
Number
11
Pages
832-836
Language
english
Notes
Publication types: Journal Article Publication Status: ppublish. pdf type: Retrospective cohort study
Abstract
OBJECTIVES: To determine characteristics associated with single and multiple fallers during postacute rehabilitation and to investigate the relationship among falls, rehabilitation outcomes, and health services use.
DESIGN: Retrospective cohort study.
SETTING: Geriatric postacute rehabilitation hospital.
PARTICIPANTS: Patients (n = 4026) consecutively admitted over a 5-year period (2003-2007).
MEASUREMENTS: All falls during hospitalization were prospectively recorded. Collected patients' characteristics included health, functional, cognitive, and affective status data. Length of stay and discharge destination were retrieved from the administrative database.
RESULTS: During rehabilitation stay, 11.4% (458/4026) of patients fell once and an additional 6.3% (253/4026) fell several times. Compared with nonfallers, fallers were older and more frequently men. They were globally frailer, with lower Barthel score and more comorbidities, cognitive impairment, and depressive symptoms. In multivariate analyses, compared with 1-time fallers, multiple fallers were more likely to have lower Barthel score (adjOR: 2.45, 95% CI: 1.48-4.07; P = .001), cognitive impairment (adjOR: 1.43, 95% CI: 1.04-1.96; P = .026), and to have been admitted from a medicine ward (adjOR: 1.55, 95% CI: 1.03-2.32; P = .035). Odds of poor functional recovery and institutionalization at discharge, as well as length of stay, increased incrementally from nonfallers to 1-time and to multiple fallers.
CONCLUSION: In these patients admitted to postacute rehabilitation, the proportion of fallers and multiple fallers was high. Multiple fallers were particularly at risk of poor functional recovery and increased health services use. Specific fall prevention programs targeting high-risk patients with cognitive impairment and low functional status should be developed in further studies.
Pubmed
Web of science
Create date
21/11/2013 18:04
Last modification date
20/08/2019 15:49
Usage data