title: Upper extremity function, an independent predictor of adverse events in hospitalized elderly.
abstract: OBJECTIVE
  To examine the relationships between upper extremity function (UEF) and mortality, need for social assistance and change of residence, at discharge from hospital and at 1 month following discharge.
  
  
  METHODS
  Observational, cohort study.
  
  
  METHODS
  Acute Geriatric Unit of a Tertiary Teaching Hospital.
  
  
  METHODS
  356 Consecutive patients admitted over a 6-month period. Performance of 4 UEF tasks (UEFTs) was assessed by direct observation on admission, at discharge and at 1 month after discharge: picking up a full glass, touching the scapula, cutting with a knife and unfastening a button. UEF was correlated with measures of global physical and mental functioning, namely the Barthel index, the Lawton index, Holden's FAC scale and Pfeiffer's test. The association of UEF with adverse events such as mortality, need for social assistance and change of residence was also assessed.
  
  
  RESULTS
  UEF was well-correlated with global functioning scales (p<0.001). Using multivariant models, the inability to perform 3 or 4 UEFTs on admission was an independent predictor of mortality at discharge (OR 15.2; CI 95% 5.2-44.4) and at 1 month (OR 3.3; CI 95% 1.8-6.2), of need for social assistance at discharge (OR 2.1; CI 95% 1.1-4.1) and at 1 month (OR 3.3; CI 95% 1.1-10.1), and of change of residence at discharge (OR 3.5; CI 95% 1.2-10.4).
  
  
  CONCLUSIONS
  UEF, independently of global functioning, is a predictor of adverse events in the hospitalized elderly. Its determination by direct observation may be an indirect measure of global functioning during hospitalization, avoiding potentially biased data facilitated by caregivers.
authors.affiliation: Geriatrics Department, Complejo Hospitalario Universitario de Albacete, Albacete, Spain. pabizanda@sescam.jccm.es
authors.forename: Pedro
authors.initials: P
authors.lastname: Abizanda
authors.forename: José L
authors.initials: JL
authors.lastname: Navarro
authors.forename: Luis
authors.initials: L
authors.lastname: Romero
authors.forename: Matilde
authors.initials: M
authors.lastname: León
authors.forename: Pedro M
authors.initials: PM
authors.lastname: Sánchez-Jurado
authors.forename: Laura
authors.initials: L
authors.lastname: Domínguez
mesh_terms: D000203:Activities of Daily Living; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003704:Dementia / Q000503:physiopathology; D004185:Disability Evaluation; D006233:Persons with Disabilities; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007902:Length of Stay; D008297:Male; D009026:Mortality; D015999:Multivariate Analysis; D020380:Needs Assessment; D010351:Patient Discharge; D011446:Prospective Studies; D013030:Spain; D034941:Upper Extremity / Q000502:physiology*