Mobility after hospital discharge as a marker for 30-day readmission

摘要

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.