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Hospital-Associated Complications of Older People: A Proposed Multicomponent Outcome for Acute Care.


ABSTRACT: OBJECTIVES:To propose a new multicomponent measure of hospital-associated complications of older people (HAC-OP) and evaluate its validity in a large hospital sample. DESIGN:Observational study using baseline (pre-intervention) data from the Collaboration for Hospitalised Elders Reducing the Impact of Stays in Hospital cluster randomized controlled trial. SETTING:Acute medical and surgical wards in 4 hospitals in Queensland, Australia. PARTICIPANTS:Individuals aged 65 and older (mean age 76, 48% female) with a hospital stay of 72 hours or longer (N=434). MEASUREMENTS:We developed a multicomponent measure including 5 well-recognized hospital-associated complications of older people: hospital-associated delirium, functional decline, incontinence, falls, and pressure injuries. To evaluate construct validity, we examined associations with common risk factors (aged ?75, functional impairment, cognitive impairment, history of falls). To evaluate predictive validity, we examined the association between length of stay, facility discharge, and 6-month mortality and any HAC-OP and total number of HAC-OP. RESULTS:Overall, 192 (44%) participants had 1 or more HAC-OP during their admission. Any HAC-OP was strongly associated with the proposed shared risk factors, and there was a strong and graded association between HAC-OP and length of stay (9.1±7.4 days for any HAC-OP vs 6.8 ±4.1 days with none, p < .001), facility discharge (59/192 (31%) vs 27/242 (11%), p < .001) and 6-month mortality (26/192 (14%) vs 17/242 (7%), p = .02). CONCLUSION:This study provides evidence of construct and predictive validity of the proposed measure of HAC-OP as a potential outcome measure for research investigating and improving hospital care of older people. J Am Geriatr Soc 67:352-356, 2019.

SUBMITTER: Mudge AM 

PROVIDER: S-EPMC6367036 | biostudies-literature | 2019 Feb

REPOSITORIES: biostudies-literature

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Hospital-Associated Complications of Older People: A Proposed Multicomponent Outcome for Acute Care.

Mudge Alison M AM   McRae Prue P   Hubbard Ruth E RE   Peel Nancye M NM   Lim Wen Kwang WK   Barnett Adrian G AG   Inouye Sharon K SK  

Journal of the American Geriatrics Society 20181113 2


<h4>Objectives</h4>To propose a new multicomponent measure of hospital-associated complications of older people (HAC-OP) and evaluate its validity in a large hospital sample.<h4>Design</h4>Observational study using baseline (pre-intervention) data from the Collaboration for Hospitalised Elders Reducing the Impact of Stays in Hospital cluster randomized controlled trial.<h4>Setting</h4>Acute medical and surgical wards in 4 hospitals in Queensland, Australia.<h4>Participants</h4>Individuals aged 6  ...[more]

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