Predictors of destination discharge in patients from a functional recovery unit in Madrid
Keywords:
HOSPITALS, REHABILITATION, RECOVERY OF FUNCTION, INPATIENTS, PATIENT DISCHARGE.Abstract
Background: the functional recovery of the patient in specialized reduce the incidence of definitive institutionalization.
Objective: o identify the predictors of destination at discharge of patients in the functional recovery unit of the Hospital Guadarrama of Madrid, Spain, from October 2021 to October 2022.
Methods: retrospective observational study, performed in the unit and time period previously defined. The sample consisted of 741 clinically stable patients under rehabilitative treatment. We evaluated: age, gender, cognitive impairment (by Pfeiffer questionnaire), comorbidities (by Charlson index), functional assessment (Barthel index), walking ability, malnutrition, confusion syndrome, respiratory infection, urinary tract infections, heart failure, functional gain, and discharge destination .
Results: Mean age of patients 78.31±11.34 years, with a degree of severe dependence on admission and high comorbidity. Functional gain was 29.53 points and 77.1 % of patients returned home. The probability that the destination at discharge outside the domicile increased 1,015 (1,004, 1,025) times for each point of increase in the Barthel index at discharge, while it decreased 0,896 (0,831, 0,967) times for each point of increase in the Pfeiffer, 0,62 (0,384, 0,979) times per point of increase in malnutrition and 0.581 (0.35, 0.978) times per point of increase in respiratory infection.
Conclusions: the better the functional situation at discharge, the greater the probability of returning home. The presence of cognitive impairment, malnutrition and respiratory infection is associated with increased risk of institutionalization.
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Baztán JJ, Domenech JR, González M, Forcano S, Morales C, Ruipérez I. Ganancia funcional y estancia hospitalaria en la unidad geriátrica de media estancia del Hospital Central de Cruz Roja de Madrid. Rev. Esp. Salud Pública [revista en internet]. 2004 [citado 4 de octubre 2023]; 78(3): 355-66. Disponible en: https://doi.org/10.1590/s1135-57272004000300005.
Labrada-Rodriguez Y, Ávila-Tato M, Cuenca-Zaldívar J. Ganancia funcional en pacientes nonagenarios tras cirugía de fractura de cadera. Revista Cubana de Ortopedia y Traumatología [revista en internet]. 2023 [citado 4 de octubre 2023]; 37(2). Disponible en: https://revortopedia.sld.cu/index.php/revortopedia/article/view/709.
Labrada-Rodríguez Y, Cuenca-Zaldívar J, Gragera-Peña P. Recuperación funcional en pacientes mayores de 85 años ingresados en una unidad de media estancia de Madrid. Revista Electrónica Dr. Zoilo E. Marinello Vidaurreta [revista en internet]. 2023 [citado 4 de octubre 2023]; 48. Disponible en: https://revzoilomarinello.sld.cu/index.php/zmv/article/view/3308.
Castellan-Vela E, Gómez-Pajares F, Rochina-Puchades A, Gil-Egea M. Factores asociados a mejoría funcional y nueva institucionalización en enfermos con intervención rehabilitadora en una unidad de media-larga estancia. Rev. Clin. Esp. [revista en internet]. 2010 [citado 7 de octubre 2023]; 210(1): 1-10. Disponible en: https://doi.org/10.1016/j.rce.2009.06.004.
Patrick L, Knoefel F, Gaskowski P, Rexroth D. Medical comorbidity and rehabilitation efficiency in geriatric inpatients. J. Am. Geriatr. Soc. [revista en internet]. 2001 [citado 7 de octubre 2023]; 49: 1471–7. Disponible en: https://doi.org/10.1046/j.1532-5415.2001.4911239.x.
Landi F, Bernabei R, Russo A, Zuccalá G, Onder G, Carosella L, Cesari M, Cocchi A. Predictors of rehabilitation outcomes in frail patients treated in a geriatric hospital. J. Am. Geriatr. Soc. [revista en internet]. 2002 [citado 7 de octubre 2023]; 50(4): 679-84. Disponible en: https://doi.org/ 10.1046/j.1532-5415.2002.50162.x.
Wong AM, Xu BY, Low LL, Allen JC Jr, Low SG. Impact of malnutrition in surgically repaired hip fracture patients admitted for rehabilitation in a community hospital: A cohort prospective study. Clin. Nutr. ESPEN. [revista en internet]. 2021 [citado 7 de octubre 2023]; 44: 188-193. Disponible en: https://doi.org/10.1016/j.clnesp.2021.06.024.
Fiorentini FJ, Gutiérrez P, Bagdonavicius J, Quirós L, Guantay P, Arroyo J, et al. Beneficios de una Unidad de Mediana Estancia en la rehabilitación de adultos mayores dependientes. Rev. Hosp. Ital. B. Aires [revista en internet]. 2020 [citado 8 de octubre 2023]; 40(1): 11-16. Disponible en: https://instituto.hospitalitaliano.org.ar/multimedia/archivos/noticias_attachs/47/documentos/110650_171-176-HI4-19-19-Fiorentini-D.pdf.
Baztán JJ, González M, Morales C, Vázquez E, Morón N, Forcano S, Ruipérez I. Variables asociadas a la recuperación funcional y la institucionalización al alta en ancianos ingresados en una unidad geriátrica de media estancia. Rev. Clin. Esp. [revista en internet]. 2004 [citado 8 de octubre 2023]; 204(11): 574-82. Disponible en: https://doi.org/10.1016/S0014-2565(04)71550-7.
Seematter-Bagnoud L, Frascarolo S, Büla CJ. How much do combined affective and cognitive impairments worsen rehabilitation outcomes after hip fracture? BMC Geriatr. [revista en internet]. 2018 [citado 4 de octubre 2023]; 18(1): 71. Disponible en: https://doi.org/10.1186/s12877-018-0763-x.
Sharma V, Sharma V, Khan A, Wassmer DJ, Schoenholtz MD, Hontecillas R, Bassaganya-Riera J, Zand R, Abedi V. Malnutrition, Health and the Role of Machine Learning in Clinical Setting. Front. Nutr. [revista en internet]. 2020 [citado 8 de octubre 2023]; 7: 44. Disponible en: https://doi.org/10.3389/fnut.2020.00044.
Roberts S, Collins P, Rattray M. Identifying and Managing Malnutrition, Frailty and Sarcopenia in the Community: A Narrative Review. Nutrients. [revista en internet]. 2021 [citado 8 de octubre 2023]; 13(7): 2316. Disponible en: https://doi.org/10.3390/nu13072316.
Cristina ML, Spagnolo AM, Giribone L, Demartini A, Sartini M. Epidemiology and Prevention of Healthcare-Associated Infections in Geriatric Patients: A Narrative Review. Int. J. Environ. Res. Public. Health [revista en internet]. 2021 [citado 8 de octubre 2023]; 18(10): 5333. Disponible en: https://doi.org/10.3390/ijerph18105333.
Esme M, Topeli A, Yavuz BB, Akova M. Infections in the Elderly Critically-Ill Patients. Front. Med. (Lausanne) [revista en internet]. 2019 [citado 8 de octubre 2023]; 6: 118. Disponible en: https://doi.org/10.3389/fmed.2019.00118.
Tannou T, Koeberle S, Manckoundia P, Aubry R. Multifactorial immunodeficiency in frail elderly patients: Contributing factors and management. Med. Mal. Infect. [revista en internet]. 2019 [citado 8 de octubre 2023]; 49(3): 167-172. Disponible en: https://doi.org/10.1016/j.medmal.2019.01.012.
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