The Predictive Validity of Functional Outcome Measures With Discharge Destination for Hospitalized Medical Patients.
Adele Myszenski, Yueren Zhou, Fuad-Tahsin Abbas and 1 others
PMID 36545519WHAT IT FOUND
Four mobility scores predicted whether hospitalized patients went home or to rehab.
Late scores near discharge were most accurate, but early AM-PAC scores also worked. A basic mobility score of 16 or higher suggested a patient would likely return home.
Key findings
01Patients discharged to home had significantly higher mean scores on all four mobility measures at both admission and discharge than those sent to post-acute facilities.
02For the AM-PAC Basic Mobility scale, a score of 16 or higher at admission was associated with a higher likelihood of returning home at discharge.
03Scores taken closest to discharge had higher odds ratios for predicting home discharge than scores taken at admission, though the authors note these late scores have less clinical value for planning.
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
This was a single-center study, so results may not apply to other hospitals or patient populations. The study was retrospective, meaning it looked back at existing records, which can introduce selection bias. Discharge destination is influenced by many factors outside of mobility, such as social support, patient preference, and insurance, which were not fully controlled for. The timing of the mobility assessments was not standardized across all patients, which could affect the reliability of the scores. Patients who died, left against medical advice, or had very long stays (over 45 days) were excluded, so the findings do not apply to these groups.
Declared interests
The authors declared no conflicts of interest. The study was approved by the Institutional Review Board with a waiver for informed consent due to its retrospective nature.
The easy way to misread this
Do not interpret the higher accuracy of discharge-time scores as a reason to wait until the end of the stay to assess mobility. The authors explicitly state these late scores have the least clinical value because they offer no time to change the outcome. Early assessment is key for actionable planning.