Relación entre discapacidad asociada a la hospitalización y recuperación funcional

To investigate the relationship between the timing of functional recovery milestones and hospitalization-associated disability (HAD) in geriatric patients ≥70 years old.

Retrospective cohort study.

A general acute care hospital.

A total of 195 patients (N=195) aged ≥70 years (mean age 81.7±7.4y; 48.2% women) who were hospitalized for acute medical conditions. Patients with baseline disability or missing key data were excluded.

Not applicable.

The HAD was defined as a ≥5-point decline in the Barthel Index compared to baseline functioning 2 weeks before admission. The relationship between HAD and the number of days to initiation of sitting, wheelchair transfer, and ambulation was examined.

The HAD occurred in 34.4% of patients. Those who developed HAD experienced significant delays in the initiation of sitting, wheelchair transfers, and ambulation. Multivariable logistic regression analysis showed that delayed initiation of wheelchair transfer and ambulation were independently associated with HAD, after adjusting for age, Barthel Index at admission, dementia, emergency admission, and total physical therapy time. Notably, the timing of ambulation initiation demonstrated moderate predictive ability for HAD (area under the curve=0.741; 95% CI, 0.656-0.825), with receiver operating characteristic analysis indicating a cut-off value of 1.5 days.

Delayed initiation of wheelchair transfer and ambulation was associated with increased risk of HAD in older hospitalized patients. Early initiation of ambulation may serve as a key target for HAD prevention strategies.