title: Functional recovery of elderly patients hospitalized in geriatric and general medicine units. The PROgetto DImissioni in GEriatria Study.
abstract: OBJECTIVE
  To investigate the characteristics of patients who regain function during hospitalization and the differences in terms of functional outcomes between patients admitted to geriatric and general medicine units.
  
  
  METHODS
  Multicenter, prospective cohort study.
  
  
  METHODS
  Acute care geriatric and medical wards of five Italian hospitals.
  
  
  METHODS
  One thousand forty-eight elderly patients hospitalized for acute medical diseases.
  
  
  METHODS
  Functional status 2 weeks before hospital admission (baseline), at admission, and at discharge, as measured using the Barthel Index (BI).
  
  
  RESULTS
  Geriatric patients were older (P<.001) and had lower preadmission functional levels (P<.001) than medical patients. Between baseline and discharge, 43.2% of geriatric and 18.9% of medical patients declined in physical function. In the subpopulation of 464 patients who had declined before hospitalization (between baseline and admission), 59% improved during hospitalization (45% of geriatric and 75% of medical patients), whereas only approximately 1% declined further. High baseline function (odds ratio (OR)=1.03, 95% confidence interval (CI)=1.02-1.04, per point of BI) and greater functional decline before hospitalization (OR 0.95, 95% CI 0.94-0.97, per % point of BI decline) were significant predictors of in-hospital functional improvement; type of hospital ward and age were not.
  
  
  CONCLUSIONS
  Although geriatric patients have overall worse functional outcomes, in-hospital functional recovery may be frequent even in geriatric units, particularly in patients with greater preadmission functional loss and high baseline level of function.
authors.affiliation: Unit of Geriatrics, Azienda Ospedaliera S. Giovanni-Addolorata, Rome, Italy.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Palleschi
authors.forename: Walter
authors.initials: W
authors.lastname: De Alfieri
authors.forename: Bernardo
authors.initials: B
authors.lastname: Salani
authors.forename: Filippo Luca
authors.initials: FL
authors.lastname: Fimognari
authors.forename: Alberto
authors.initials: A
authors.lastname: Marsilii
authors.forename: Andrea
authors.initials: A
authors.lastname: Pierantozzi
authors.forename: Luigi
authors.initials: L
authors.lastname: Di Cioccio
authors.forename: Stefano Maria
authors.initials: SM
authors.lastname: Zuccaro
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology*; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D015577:Geriatric Assessment; D006299:Health Services for the Aged; D006760:Hospitalization / Q000639:trends; D006769:Hospitals, General; D006801:Humans; D007297:Inpatients; D007558:Italy; D007902:Length of Stay / Q000639:trends; D008297:Male; D009043:Motor Activity / Q000502:physiology*; D010351:Patient Discharge / Q000639:trends; D011379:Prognosis; D011446:Prospective Studies; D020127:Recovery of Function