Association between patients' state upon admission and decline in activities of daily living.
Tomoyuki Shinohara, Naoko Tsuchida, Tatsuya Yamane and 3 others
PMID 31645812WHAT IT FOUND
Inpatients with low initial function saw the biggest drops in transfer and toilet use.
Those with high initial function saw the biggest drops in bathing and stairs. Screen patients based on their admission Barthel Index to target prevention.
Key findings
0149 of 2,460 inpatients experienced a Barthel Index decline of more than 5 points from admission to discharge.
02Patients in the low ADL group at admission saw significant declines in transfer and toilet use.
03Patients in the high ADL group at admission saw significant declines in bathing and ascending/descending stairs.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study was single-center and conducted over a limited period. Multivariate analysis was not possible due to the small number of patients with decline (49). The specific components and volume of rehabilitation were not analyzed, so the effect of treatment intensity is unknown. Patients who died before discharge were excluded, which may bias the sample toward survivors.
Declared interests
The authors declared no financial or personal relationships to disclose.
The easy way to misread this
Do not assume that all inpatients lose the same skills. The specific ADL items at risk depend heavily on the patient's function level at admission, so a one-size-fits-all prevention strategy may miss the most vulnerable activities for each individual.