Hospital-Associated Complications of Older People: A Proposed Multicomponent Outcome for Acute Care.
J Am Geriatr Soc
; 67(2): 352-356, 2019 02.
Article
en En
| MEDLINE
| ID: mdl-30423197
ABSTRACT
OBJECTIVES:
To propose a new multicomponent measure of hospital-associated complications of older people (HAC-OP) and evaluate its validity in a large hospital sample.DESIGN:
Observational study using baseline (pre-intervention) data from the Collaboration for Hospitalised Elders Reducing the Impact of Stays in Hospital cluster randomized controlled trial.SETTING:
Acute medical and surgical wards in 4 hospitals in Queensland, Australia.PARTICIPANTS:
Individuals aged 65 and older (mean age 76, 48% female) with a hospital stay of 72 hours or longer (N=434). MEASUREMENTS We developed a multicomponent measure including 5 well-recognized hospital-associated complications of older people hospital-associated delirium, functional decline, incontinence, falls, and pressure injuries. To evaluate construct validity, we examined associations with common risk factors (aged ≥75, functional impairment, cognitive impairment, history of falls). To evaluate predictive validity, we examined the association between length of stay, facility discharge, and 6-month mortality and any HAC-OP and total number of HAC-OP.RESULTS:
Overall, 192 (44%) participants had 1 or more HAC-OP during their admission. Any HAC-OP was strongly associated with the proposed shared risk factors, and there was a strong and graded association between HAC-OP and length of stay (9.1±7.4 days for any HAC-OP vs 6.8 ±4.1 days with none, p < .001), facility discharge (59/192 (31%) vs 27/242 (11%), p < .001) and 6-month mortality (26/192 (14%) vs 17/242 (7%), p = .02).CONCLUSION:
This study provides evidence of construct and predictive validity of the proposed measure of HAC-OP as a potential outcome measure for research investigating and improving hospital care of older people. J Am Geriatr Soc 67352-356, 2019.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Evaluación de Resultado en la Atención de Salud
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Cuidados Críticos
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Hospitales
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Enfermedad Iatrogénica
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Tiempo de Internación
Tipo de estudio:
Clinical_trials
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Límite:
Aged
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Aged80
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Female
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Humans
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Male
País/Región como asunto:
Oceania
Idioma:
En
Revista:
J Am Geriatr Soc
Año:
2019
Tipo del documento:
Article
País de afiliación:
Australia