[Application of a short version of the Barthel Index for functional stratification in inpatients with multiple pathology (Mini-Barthel)].

Abstract

Introduction: Functional impairment is prevalent in patients with multiple pathologies (PP) and implies the need for caregivers, impaired quality of life, and increased mortality. The objective was to evaluate the functional stratification and prognostic performance of the MiniBarthel (MB), a short, simplified, three-dimensional version of the Barthel Index (BI), in hospitalized PP.

Materials and methods: A prospective, observational study was conducted. The PROFUND prognostic score was administered upon admission, and patients were classified as MB0 (cannot do anything alone), MB1 (can feed themselves), MB2 (can feed and ambulate alone), and MB3 (can feed, ambulate, and climb stairs alone) by the attending physician. The BI was determined by the physical therapist to maintain the blinding. A 12-month follow-up was conducted to assess survival.

Results: Ninety-nine patients were enrolled in the study, of whom 50 (50.5%) died during follow-up. They classified 21%, 17%, 17%, and 44% of patients as MB0, MB1, MB2, and MB3, with a median (IQR) BI of 10 (5- 20), 50 (40-60), 85 (75-90), and 95 (80-100) p < 0.001 and mortality of 66%, 64%, 52%, and 34% p 0.014, respectively. The area under the curve (AUC) (95% CI) of PROFUND, IB, and MB to discriminate 12-month mortality was 0.661 (0.553-0.769), 0.655 (0.547-0.762), and 0.654 (0.546-0.749), respectively.

Conclusion: The Mini-Barthel's high performance, simplicity, and ease of use for functional stratification would enable a proactive approach to frailty and dependency care, focusing on functional decline and prognosis in hospitalized patients with multiple pathologies.