Frailty risk in hospitalised older adults with and without diabetes mellitus.
J Clin Nurs
; 27(19-20): 3510-3521, 2018 Oct.
Article
em En
| MEDLINE
| ID: mdl-29777549
ABSTRACT
BACKGROUND:
Research indicates that diabetes mellitus (DM) may be a risk factor for frailty and individuals with DM are more likely to be frail than individuals without DM; however, there is limited research in hospitalised older adults.OBJECTIVES:
To determine the extent of frailty in hospitalised older adults with and without DM using a 16-item Frailty Risk Score (FRS) and assess the role of frailty in predicting 30-day rehospitalisation, discharge to an institution and in-hospital mortality.METHODS:
The study was a retrospective, cohort, correlational design and secondary analysis of a data set consisting of electronic health record data. The sample was older adults hospitalised on medicine units. Logistic regression was performed for 30-day rehospitalisation and discharge location. Cox proportional hazards regression was used to analyse time to in-hospital death and weighted using propensity scores.RESULTS:
Of 278 hospitalised older adults, 49% had DM, and the mean FRS was not significantly different by DM status (9.6 vs. 9.1, p = 0.07). For 30-day rehospitalisation, increased FRS was associated with significantly increased odds of rehospitalisation (AOR = 1.24, 95% CI [1.01, 1.51], p = 0.04). Although 81% were admitted from home, 57% were discharged home and 43% to an institution. An increased FRS was associated with increased odds of discharge to an institution (AOR = 1.48, 95% CI [1.26, 1.74], p < 0.001). The FRS was not significantly associated with increased risk of in-hospital death (p = 0.17), but DM was associated with a 484% increase in the instantaneous risk of death (AHR = 5.84, 95% CI [1.71, 19.9], p = 0.005).CONCLUSION:
Diabetes mellitus and frailty were highly prevalent; the mean FRS was not significantly different by DM status. Although increased frailty was significantly associated with rehospitalisation and discharge to an institution, only DM was significantly associated with in-hospital mortality. RELEVANCE TO CLINICAL PRACTICE Frailty assessment may augment clinical assessment and facilitate tailoring care and determining optimal outcomes in patients with and without DM.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Complicações do Diabetes
/
Fragilidade
/
Hospitalização
Tipo de estudo:
Etiology_studies
/
Observational_studies
/
Prevalence_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Aged
/
Aged80
/
Female
/
Humans
/
Male
Idioma:
En
Revista:
J Clin Nurs
Assunto da revista:
ENFERMAGEM
Ano de publicação:
2018
Tipo de documento:
Article