title: Mobility after hospital discharge as a marker for 30-day readmission.
abstract: BACKGROUND
  Little is known about older patient's mobility soon after discharge home from an acute hospitalization. We examined daily postdischarge mobility levels as marker of overall health and response to in-hospital treatment in older medicine patients.
  
  
  METHODS
  One hundred and eleven ambulatory men and women aged 65 years and older hospitalized with an acute medical illness and discharged to home were studied. Patients received an ankle-worn accelerometer during hospitalization and wore it continually for up to 1 week after discharge. Total number of steps taken per day was assessed. The primary outcome was all-cause 30-day readmission.
  
  
  RESULTS
  Thirteen (11.7%) participants were readmitted within 30 days of discharge. There was a significant association between mean daily steps taken postdischarge and 30-day readmission (odds ratio = 0.85, 95% confidence interval = 0.72-0.99, and p = .04; odds ratio and confidence intervals were calculated for 500-step intervals). Though not statistically significant in the fully adjusted model (odds ratio = 0.83, 95% confidence interval = 0.71-1.02, and p = .08), mean daily steps was the strongest predictor among known readmission risk factors. The least active participants postdischarge were significantly more likely to be older (p = .02), be not married (p = .02), use a cane or walker prior to admission (p < .01), have longer lengths of hospital stay (p = .02), and be readmitted (p = .05).
  
  
  CONCLUSIONS
  Mobility level soon after discharge home shows promise as a simple physical biomarker of overall health and risk of 30-day readmission in older patients.
authors.affiliation: Department of Physical Therapy, University of Texas Medical Branch, 301 University Blvd, Galveston, TX 77555-0460, USA. stfisher@utmb.edu
authors.forename: Steve R
authors.initials: SR
authors.lastname: Fisher
authors.forename: Yong-Fang
authors.initials: YF
authors.lastname: Kuo
authors.forename: Gulshan
authors.initials: G
authors.lastname: Sharma
authors.forename: Mukaila A
authors.initials: MA
authors.lastname: Raji
authors.forename: Amit
authors.initials: A
authors.lastname: Kumar
authors.forename: James S
authors.initials: JS
authors.lastname: Goodwin
authors.forename: Glenn V
authors.initials: GV
authors.lastname: Ostir
authors.forename: Kenneth J
authors.initials: KJ
authors.lastname: Ottenbacher
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D051346:Mobility Limitation; D010351:Patient Discharge / Q000706:statistics & numerical data*; D010359:Patient Readmission / Q000706:statistics & numerical data*; D019984:Quality Indicators, Health Care / Q000706:statistics & numerical data*; D018570:Risk Assessment; D012307:Risk Factors; D013781:Texas; D013997:Time Factors