The Short Physical Performance Battery (SPPB) and the De Morton Mobility Index (DEMMI) are two commonly used instruments to assess mobility in older patients.
To compare the two assessments in acute senior trauma patients with regard to sensitivity to change during an acute care, and prediction of discharge destination.
Medical records were extracted for consecutive trauma patients aged 70 + receiving acute care rehabilitation in the geriatric ward during 9 months. SPPB and DEMMI were obtained at admission and discharge. Sensitivity was analyzed using paired t tests and Cohen’s d, and discharge destination with logistic regression predicting the probability of returning home.
A total of 69 patients were included in the study [83.7 years (SD 6.3), 78% women, length of stay 10 (IQR 8–10) days]. Overall, SPPB improved from 2.0 (SD 2.5) to 3.8 (SD 2.7; p ≤ 0.001) and DEMMI from 41 (SD 19) to 53 (SD 14; p ≤ 0.001) (Cohen’s d: 0.72 for SPPB, 0.62 for DEMMI). Among patients admitted from home each additional point in SPPB at admission and acquired during acute care rehabilitation increased the odds of returning home by 1.7 times (95% CI 1.1–2.8, p = 0.02) and 1.6 times (95% CI 1.1–2.5, p = 0.02). For DEMMI, every 10 points at admission, but not in change, increased the odds of returning home by 2.5 times (95% CI 1.3–5.0, p = 0.007).
Discussion and conclusion
SPPB and DEMMI are both valid mobility assessments for senior patients in acute care. However, SPPB is a better predictor than DEMMI for discharge destination.