Inpatient Walking Activity to Predict Readmission in Older Adults.
Steve R Fisher, James E Graham, Kenneth J Ottenbacher and 2 others
PMID 27264549WHAT IT FOUND
In older inpatients, lower average daily hospital steps were associated with higher 30-day readmission risk.
This observational finding does not prove that increasing walking would reduce readmissions.
Key findings
01Mean daily steps were 323 for readmitted patients and 674 for patients who were not readmitted.
02Each 100-step increase in mean daily steps was associated with approximately 10% lower odds of readmission in models adjusted for age and gender.
03A cut-point of 475 mean daily steps was produced by both ROC threshold methods.
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 final analysis included 164 patients, and only 26 had readmission, so the sample was small for this outcome. The sample excluded patients who were too ill to consent on admission day, cognitively impaired patients, and patients with musculoskeletal or neurologic conditions, so it may not apply to more impaired or differently diagnosed inpatients. Readmission was counted only at the same hospital, so readmission to another hospital was missed and the true readmission count may be undercounted. No activity data were collected immediately before admission, so the study could not separate hospitalization effects from the patient's usual activity. This was observational, so it did not test whether increasing walking reduced readmission.
The easy way to misread this
Do not treat the suggested step threshold as a proven target for preventing readmission. This was an observational study, so it shows association, not that increasing walking caused fewer readmissions.