Factors associated with functional decline of hospitalised older persons following discharge from an acute geriatric unit.
BACKGROUND
Older persons are likely to develop functional impairment following hospitalisation. Several studies in the West have examined the factors associated with functional decline following the older person's discharge from hospital but there are little data on Asian populations. This study aims to look at the associated risk factors in our local population, following admission to an acute geriatric unit.


METHODS
This is a retrospective, cohort study. Patients who were discharged from an inpatient geriatric unit over a 3-month period were recruited. Data including their demographic information, functional status prior to admission and at the time of discharge, and medical conditions were obtained from the inpatient medical notes. A follow-up telephone interview was conducted at 3 months to determine the functional status of these patients at that point in time.


RESULTS
Following hospitalisation, 40.4% of patients developed functional decline. Of those discharged, 29.6% showed functional decline at 3 months. The principal diagnosis, hypoalbuminaemia, tendency to fall, premorbid functional independence and the length of hospitalisation were associated with functional decline during hospitalisation, while hypoalbuminaemia, the presence of bedsores, institutionalisation, the length of hospitalisation and premorbid functional dependence were important factors associated with functional decline between the time of discharge and 3 months after. In the multivariable predictive model, independent predictors of functional decline at the time of discharge included patient's tendency to fall, premorbid functional independence and the length of hospitalisation, while the presence of bedsores was the only significant predictor of functional decline 3 months post-discharge.


CONCLUSIONS
Many elderly patients developed new functional impairment following hospitalisation. Several factors were found to be associated with this functional decline, though no single predictive model similar to the other published studies was identified.
Wu
H Y
HY
Department of Geriatric Medicine, Tan Tock Seng Hospital, Singapore. huei_yaw_wu@ttsh.com.sg
Sahadevan
S
S
Ding
Y Y
YY
D000058:Accidental Falls; D000203:Activities of Daily Living; D000359:Aftercare; D000368:Aged / Q000502:physiology*; D000369:Aged, 80 and over / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D016330:Frail Elderly; D015577:Geriatric Assessment; D006757:Hospital Units; D006801:Humans; D007326:Institutionalization; D007902:Length of Stay; D008297:Male; D010351:Patient Discharge; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012846:Singapore; D013997:Time Factors