Predictors of regaining ambulatory ability during hospitalization

✍ Scribed by Cynthia J. Brown; David L. Roth; Claire Peel; Richard M. Allman

• Publisher: John Wiley and Sons
• Year: 2006
• Tongue: English
• Weight: 114 KB
• Volume: 1
• Category: Article
• ISSN: 1553-5592
• DOI: 10.1002/jhm.104

✦ Synopsis

Abstract

BACKGROUND

Loss of ambulatory ability with acute hospitalization is common and often does not improve by discharge.

OBJECTIVES

To define admission predictors of regaining ambulatory ability during hospitalization in patients with expected activity limitations.

DESIGN

Prospective cohort study.

SETTING

University teaching hospital.

PARTICIPANTS

Two hundred and eighty‐six patients at least 55 years of age whose activity was expected to be limited to a bed or chair for at least the first 5 days of hospitalization or who had a hip fracture, who were ambulatory in the 4 weeks prior to hospital admission, and whose length of stay in the hospital was less than 32 days.

MEASUREMENTS

Baseline data collected from admission physician and nurse interviews and abstracted from the medical records included length of stay, demographic characteristics, global health measures, presence of specific diseases, and hospital‐related factors hypothesized to affect ambulation. Nurses were asked weekly if patient activity was still expected to be limited to a bed or chair.

RESULTS

Despite initially being limited to a bed or chair, 42% had regained ambulatory ability by discharge. Recovery of ambulatory ability was independently associated with not being married (odds ratio [OR] = 3.0, 95% confidence interval [CI] 1.4‐6.2), higher physician‐rated life expectancy (OR = 1.9, 95% CI 1.3‐2.8), absence of restraints (OR = 2.5, 95% CI 1.2‐5.5), having a urinary catheter (OR = 2.2, 95% CI 1.2‐5.5), having deep vein thrombosis (OR = 11.4, 95% CI 1.2‐105.1), and having a higher level of bed mobility at admission (OR = 1.7, 95% CI 1.1‐2.6).

CONCLUSIONS

Recovery of ambulatory ability is closely associated with physician‐rated life expectancy and hospital‐related factors, particularly those that affect mobility. Early recognition of who will recover ambulatory ability may help with discharge planning and potential interventions. Journal of Hospital Medicine 2006;1:277–284. © 2006 Society of Hospital Medicine.