title: Predictors of functional recovery (FR) for elderly hospitalized patients in a geriatric evaluation and management unit (GEMU) in Taiwan.
abstract: Elderly patients who are hospitalized with acute illnesses frequently have adverse outcomes. To maintain functional independence, the geriatric evaluation and management unit (GEMU) was established to provide the opportunity for functional recovery (FR). This study's aim was to investigate potential prognostic factors for functional improvement in a GEMU of Taichung Veterans General Hospital, Taiwan. A total of 117 elderly patients (age, 80.0+/-6.3 years, 84.6% males) were enrolled. A comprehensive geriatric assessment and functional status evaluation, including the functional reach test (FRT) and the timed up-and-go (TUG) test, were performed. FR was defined by a greater than 10% improvement in the Barthel Index (BI) before GEMU discharge. Lower BI (44.7+/-25.2 vs. 68.7+/-34.5, p < 0.001), lower instrumental activities of daily living (IADL) scores (1.8+/-1.5 vs. 3.5+/-2.6, p < 0.001), impaired FRT (83.3% vs. 63.5%, p = 0.028), and impaired TUG test (94.4% vs. 74.6%, p = 0.008) were predictive factors for functional improvement. On multivariate logistic regression, an impaired TUG test (Odds ratio = OR = 6.18, 95% confidence interval = 95% C.I. = 1.69-22.6, p = 0.006) was an independent variable associated with FR. The results indicate that elderly hospitalized patients, even with poor physical function, could benefit from geriatric integrated care delivered by a GEMU.
authors.affiliation: Division of Allergy, Immunology and Rheumatology, Taichung Veterans General Hospital, No. 160 Section 3 Taichung-Kang Road, Taichung, Taiwan.
authors.forename: Yi-Ming
authors.initials: YM
authors.lastname: Chen
authors.forename: Ya-Wen
authors.initials: YW
authors.lastname: Chuang
authors.forename: Szu-Chia
authors.initials: SC
authors.lastname: Liao
authors.forename: Chu-Sheng
authors.initials: CS
authors.lastname: Lin
authors.forename: Shu-Hui
authors.initials: SH
authors.lastname: Yang
authors.forename: Yih-Jing
authors.initials: YJ
authors.lastname: Tang
authors.forename: Jaw-Ji
authors.initials: JJ
authors.lastname: Tsai
authors.forename: Jong-Liang
authors.initials: JL
authors.lastname: Lan
authors.forename: Der-Yuan
authors.initials: DY
authors.lastname: Chen
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data*; D000203:Activities of Daily Living; D000368:Aged; D003072:Cognition Disorders / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D015577:Geriatric Assessment; D006299:Health Services for the Aged; D006304:Health Status; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000175:diagnosis* / Q000453:epidemiology; D009043:Motor Activity; D011237:Predictive Value of Tests; D015995:Prevalence; D011446:Prospective Studies; D020127:Recovery of Function; D013624:Taiwan / Q000453:epidemiology; D014549:Urinary Incontinence / Q000175:diagnosis* / Q000453:epidemiology; D000078329:Workforce