{"title":"Prognostic factors in mobility disability among elderly patients in the emergency department: A single-center retrospective study","authors":"Akiyoshi Nagatomi, Haruaki Wakatake, Yoshihiro Masui, Shigeki Fujitani","doi":"10.1002/ams2.951","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Aim</h3>\n \n <p>We aimed to evaluate the clinical characteristics and outcomes of elderly critically ill patients and identify prognostic factors for mobility disability at discharge.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>This single-center, retrospective cohort study investigated the period from April 2020 to January 2021. Patients ≥75 years old transferred to our emergency department and admitted to the intensive care unit (ICU) or intermediate unit in our hospital were eligible. Demographics, clinical characteristics, nutritional indicators, and nutritional screening scores were collected from chart reviews and analyzed. The primary outcome was the prevalence of mobility disability, compared to that of no mobility disability.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>A total of 124 patients were included in this present study. Median age was 83.0 years (interquartile range [IQR], 79.8–87.0 years) and 48 patients (38.7%) were female. Fifty-two patients (41.9%) could not walk independently at discharge (mobility disability group). The remaining 72 patients were in the no mobility disability group. Multiple logistic regression analyses revealed clinical frailty scale (CFS) score ≥5 (odds ratio [OR] = 6.63, 95% confidence interval [CI] = 2.51–17.52, <i>p</i> < 0.001), SOFA score ≥6 (OR = 6.11, 95% CI = 1.57–23.77, <i>p</i> = 0.009), and neurological disorder as the main cause on admission (OR = 4.48, 95% CI = 1.52–13.20, <i>p</i> = 0.006) were independent and significant prognostic factors for mobility disability at discharge.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>Among elderly patients admitted to the emergency department, CFS ≥5, SOFA ≥6, and neurological disorders were associated with mobility disability at hospital discharge.</p>\n </section>\n </div>","PeriodicalId":7196,"journal":{"name":"Acute Medicine & Surgery","volume":null,"pages":null},"PeriodicalIF":1.5000,"publicationDate":"2024-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ams2.951","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Acute Medicine & Surgery","FirstCategoryId":"1085","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/ams2.951","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
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Abstract
Aim
We aimed to evaluate the clinical characteristics and outcomes of elderly critically ill patients and identify prognostic factors for mobility disability at discharge.
Methods
This single-center, retrospective cohort study investigated the period from April 2020 to January 2021. Patients ≥75 years old transferred to our emergency department and admitted to the intensive care unit (ICU) or intermediate unit in our hospital were eligible. Demographics, clinical characteristics, nutritional indicators, and nutritional screening scores were collected from chart reviews and analyzed. The primary outcome was the prevalence of mobility disability, compared to that of no mobility disability.
Results
A total of 124 patients were included in this present study. Median age was 83.0 years (interquartile range [IQR], 79.8–87.0 years) and 48 patients (38.7%) were female. Fifty-two patients (41.9%) could not walk independently at discharge (mobility disability group). The remaining 72 patients were in the no mobility disability group. Multiple logistic regression analyses revealed clinical frailty scale (CFS) score ≥5 (odds ratio [OR] = 6.63, 95% confidence interval [CI] = 2.51–17.52, p < 0.001), SOFA score ≥6 (OR = 6.11, 95% CI = 1.57–23.77, p = 0.009), and neurological disorder as the main cause on admission (OR = 4.48, 95% CI = 1.52–13.20, p = 0.006) were independent and significant prognostic factors for mobility disability at discharge.
Conclusion
Among elderly patients admitted to the emergency department, CFS ≥5, SOFA ≥6, and neurological disorders were associated with mobility disability at hospital discharge.