Association Between Physical Activity Levels in the Hospital Setting and Hospital-Acquired Functional Decline in Elderly Patients.

Détails

Ressource 1Télécharger: Jama open 2020.pdf (997.37 [Ko])
Etat: Public
Version: Final published version
Licence: CC BY 4.0
ID Serval
serval:BIB_B3E45B0D9A45
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Association Between Physical Activity Levels in the Hospital Setting and Hospital-Acquired Functional Decline in Elderly Patients.
Périodique
JAMA network open
Auteur(s)
Tasheva P., Vollenweider P., Kraege V., Roulet G., Lamy O., Marques-Vidal P., Méan M.
ISSN
2574-3805 (Electronic)
ISSN-L
2574-3805
Statut éditorial
Publié
Date de publication
03/01/2020
Peer-reviewed
Oui
Volume
3
Numéro
1
Pages
e1920185
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: epublish
Résumé
The effects of in-hospital physical activity (PA) on outcomes among elderly patients has seldom been assessed.
To assess PA levels among elderly patients hospitalized for acute medical illness and to examine the association between PA levels and functional decline and other clinical outcomes at discharge.
This monocentric cohort study was performed among patients 65 years or older who were admitted for acute medical illness to the internal medicine ward of Lausanne University Hospital, Lausanne, Switzerland, from February 1 through November 30, 2018. Data were analyzed from January 1 through December 2, 2019.
Daytime and 24-hour PA levels assessed via wrist accelerometers and measured in millig units (mG; 1 mG = 9.80665 × 10-3 m/s2).
Functional decline (defined as a ≥5-point decrease in the modified Barthel Index), risk of bedsores, length of stay (LOS), and inability to return home.
A total of 177 patients (106 [59.9%] men; median age, 83 [interquartile range, 74-87] years) were included. Lower mean (SD) PA levels were found in patients using walking aids before admission (daytime, 12 [5] vs 15 [7] mG; 24-hour, 10 [3] vs 11 [5] mG), those admitted for a reason associated with functional decline (daytime, 12 [6] vs 14 [7] mG; 24-hour, 10 [4] vs 11 [4] mG), or those prescribed physiotherapy (daytime, 12 [5] vs 15 [7] mG; 24-hour, 10 [4] vs 12 [5] mG). At discharge, functional decline was found in 63 patients (35.6%; 95% CI, 25.6%-43.1%), bedsore risk in 78 (44.1%; 95% CI, 36.6%-51.7%), and inability to return home in 82 (46.3%; 95% CI, 38.8%-54.0%). After multivariate analysis, no association was found between PA levels and functional decline (multivariable-adjusted mean [SE], 13 [1] vs 13 [1] mG for daytime levels [P = .69] and 10 [1] vs 11 [1] mG for 24-hour PA levels [P = .45]) or LOS (Spearman rank correlation, ρ = -0.06 for daytime PA levels [P = .93] and -0.01 for 24-hour PA levels [P = .52]). Patients at risk of bedsores had significantly lower PA levels than those not at risk (multivariable-adjusted mean [SE], 12 [1] vs 15 [1] mG for daytime PA levels [P = .008]; 10 [1] vs 12 [1] mG for 24-hour PA levels [P = .01]). Patients able to return home had significantly higher PA levels than those institutionalized (multivariable-adjusted mean [SE], 14 [1] vs 12 [1] mG for daytime PA levels [P = .04]; 11 [1] vs 10 [1] mG for 24-hour PA levels [P = .009]).
In this study, lower in-hospital daytime and 24-hour PA levels were associated with risk of bedsores and inability to return home on discharge. These findings are important given that one-third of elderly patients present with hospital-acquired functional decline.
Mots-clé
Aged, Aged, 80 and over, Cognition/physiology, Cohort Studies, Exercise/physiology, Female, Frail Elderly, Hospitalization, Humans, Iatrogenic Disease/prevention & control, Male, Switzerland
Pubmed
Web of science
Open Access
Oui
Création de la notice
06/02/2020 18:50
Dernière modification de la notice
12/08/2020 6:22
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