Nonlinear Relationship Between Vital Signs and Hospitalization/Emergency Department Visits Among Older Home Healthcare Patients and Critical Vital Sign Cutoff for Adverse Outcomes: Application of Generalized Additive Model.
Se Hee Min, Jiyoun Song, Lauren Evans and 6 others
PMID 40357664WHAT IT FOUND
Among older home healthcare patients, hospitalization or ED visits were linked to a U-shaped risk pattern.
Heart rate above 83.24 was linked to a sharp rise in modeled risk; critical points were 120.36 for systolic and 72.00 for diastolic pressure.
Key findings
01Heart rate showed the most pronounced nonlinear relationship with hospitalization or ED visits, and risk may increase sharply above 83.24.
02Systolic and diastolic blood pressure showed U-shaped relationships with hospitalization or ED visits, with critical inflection points at 120.36 and 72.00.
03The heart rate inflection point was weaker statistically than the blood pressure inflection points.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This was an observational record analysis, so it cannot show that any vital sign caused hospitalization or ED visits. Only vital signs at admission were analyzed, not repeated measurements during the home healthcare episode. The study focused on nonlinear vital signs and did not analyze respiratory rate or temperature in the main models. The heart rate inflection point had p = .052, so it was weaker than the blood pressure inflection points. The sample came from one of the largest home healthcare agencies in the northeastern U.S., so the thresholds may not transfer to other settings. Older adults were not examined separately by young-old, old-old and oldest-old age groups.
Declared interests
The authors declared no potential conflicts of interest. The study was funded by the Agency for Healthcare Research and Quality under grant R01 HS027742.
The easy way to misread this
Do not treat 83.24 as a universal cutoff or as proof that heart rate causes hospitalization or ED visits. This is an observational study of admission vital signs, and the heart rate inflection point had p = .052.