Alison M Mudge1,2, Prue McRae1,2, Ruth E Hubbard3, Nancye M Peel3, Wen Kwang Lim4,5, Adrian G Barnett2, Sharon K Inouye6. 1. Internal Medicine Research Unit, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia. 2. Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia. 3. Centre for Research in Geriatric Medicine, University of Queensland, Brisbane, Queensland, Australian. 4. Royal Melbourne Hospital, Melbourne, Victoria, Australia. 5. University of Melbourne, Melbourne, Victoria, Australia. 6. Institute for Aging Research, Hebrew Senior Life, Harvard Medical School, Boston, Massachusetts.
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 67:352-356, 2019.
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 67:352-356, 2019.
Authors: Mary H Palmer; Mona Baumgarten; Patricia Langenberg; Jeffrey L Carson Journal: J Gerontol A Biol Sci Med Sci Date: 2002-10 Impact factor: 6.053
Authors: Jennifer Watt; Andrea C Tricco; Catherine Talbot-Hamon; Ba' Pham; Patricia Rios; Agnes Grudniewicz; Camilla Wong; Douglas Sinclair; Sharon E Straus Journal: J Gen Intern Med Date: 2018-01-26 Impact factor: 5.128
Authors: Kathryn Anzuoni; Terry S Field; Kathleen M Mazor; Yanhua Zhou; Lawrence D Garber; Alok Kapoor; Jerry H Gurwitz Journal: J Am Geriatr Soc Date: 2020-07-25 Impact factor: 5.562
Authors: Jennifer K Burton; Louise Craig; Shun Qi Yong; Najma Siddiqi; Elizabeth A Teale; Rebecca Woodhouse; Amanda J Barugh; Alison M Shepherd; Alan Brunton; Suzanne C Freeman; Alex J Sutton; Terry J Quinn Journal: Cochrane Database Syst Rev Date: 2021-11-26
Authors: Danielle Ní Chróinín; Nevenka Francis; Pearl Wong; Yewon David Kim; Susan Nham; Scott D'Amours Journal: Trauma Surg Acute Care Open Date: 2021-04-27
Authors: Jeremy W Tankel; David Ratcliffe; Martin Smith; Andrew Mullarkey; Jennifer Pover; Zoe Marsden; Paula Bennett; Darren Green Journal: BMC Emerg Med Date: 2021-05-01
Authors: Jennifer L Carnahan; Lev Inger; Susan M Rawl; Tochukwu C Iloabuchi; Daniel O Clark; Christopher M Callahan; Alexia M Torke Journal: J Gen Intern Med Date: 2020-11-02 Impact factor: 5.128