OBJECTIVE: The primary aims of this study were to design prediction models based on a functional marker (preoperative gait speed) to predict readiness for home discharge time of 90 mins or less and to identify those at risk for unplanned admissions after elective ambulatory surgery. DESIGN: This prospective observational cohort study evaluated all patients scheduled for elective ambulatory surgery. Home discharge readiness and unplanned admissions were the primary outcomes. Independent variables included preoperative gait speed, heart rate, and total anesthesia time. The relationship between all predictors and each primary outcome was determined in separate multivariable logistic regression models. RESULTS: After adjustment for covariates, gait speed with adjusted odds ratio of 3.71 (95% confidence interval, 1.21-11.26), P = 0.02, was independently associated with early home discharge readiness of 90 mins or less. Importantly, gait speed dichotomized as greater or less than 1 m/sec predicted unplanned admissions, with odds ratio of 0.35 (95% confidence interval, 0.16-0.76, P = 0.008) for those with speeds 1 m/sec or greater in comparison with those with speeds less than 1 m/sec. In a separate model, history of cardiac surgery with adjusted odds ratio of 7.5 (95% confidence interval, 2.34-24.41; P = 0.001) was independently associated with unplanned admissions after elective ambulatory surgery, when other covariates were held constant. CONCLUSIONS: This study demonstrates the use of novel prediction models based on gait speed testing to predict early home discharge and to identify those patients at risk for unplanned admissions after elective ambulatory surgery.
OBJECTIVE: The primary aims of this study were to design prediction models based on a functional marker (preoperative gait speed) to predict readiness for home discharge time of 90 mins or less and to identify those at risk for unplanned admissions after elective ambulatory surgery. DESIGN: This prospective observational cohort study evaluated all patients scheduled for elective ambulatory surgery. Home discharge readiness and unplanned admissions were the primary outcomes. Independent variables included preoperative gait speed, heart rate, and total anesthesia time. The relationship between all predictors and each primary outcome was determined in separate multivariable logistic regression models. RESULTS: After adjustment for covariates, gait speed with adjusted odds ratio of 3.71 (95% confidence interval, 1.21-11.26), P = 0.02, was independently associated with early home discharge readiness of 90 mins or less. Importantly, gait speed dichotomized as greater or less than 1 m/sec predicted unplanned admissions, with odds ratio of 0.35 (95% confidence interval, 0.16-0.76, P = 0.008) for those with speeds 1 m/sec or greater in comparison with those with speeds less than 1 m/sec. In a separate model, history of cardiac surgery with adjusted odds ratio of 7.5 (95% confidence interval, 2.34-24.41; P = 0.001) was independently associated with unplanned admissions after elective ambulatory surgery, when other covariates were held constant. CONCLUSIONS: This study demonstrates the use of novel prediction models based on gait speed testing to predict early home discharge and to identify those patients at risk for unplanned admissions after elective ambulatory surgery.
Authors: Martine T E Puts; Johanne Monette; Veronique Girre; Carmela Pepe; Michele Monette; Sarit Assouline; Lawrence Panasci; Mark Basik; Wilson H Miller; Gerald Batist; Christina Wolfson; Howard Bergman Journal: Crit Rev Oncol Hematol Date: 2010-05-04 Impact factor: 6.312
Authors: Jonathan F Bean; Dan K Kiely; Sharon LaRose; Richard Goldstein; Walter R Frontera; Suzanne G Leveille Journal: J Am Geriatr Soc Date: 2010-12 Impact factor: 5.562
Authors: Emily S Patterson; Bradley N Doebbeling; Constance H Fung; Laura Militello; Shilo Anders; Steven M Asch Journal: J Biomed Inform Date: 2004-12-15 Impact factor: 6.317
Authors: Jason R Falvey; Robert E Burke; Daniel Malone; Kyle J Ridgeway; Beth M McManus; Jennifer E Stevens-Lapsley Journal: Phys Ther Date: 2016-03-03