Header

UZH-Logo

Maintenance Infos

Physical performance among patients aged 70 + in acute care: a preliminar comparison between the Short Physical Performance Battery and the De Morton Mobility Index with regard to sensitivity to change and prediction of discharge destination


Gazzotti, A; Meyer, U; Freystaetter, G; Palzer, M; Theiler, R; Abderhalden, L; Bischoff-Ferrari, H A (2020). Physical performance among patients aged 70 + in acute care: a preliminar comparison between the Short Physical Performance Battery and the De Morton Mobility Index with regard to sensitivity to change and prediction of discharge destination. Aging Clinical and Experimental Research, 32(4):579-586.

Abstract

Background
The Short Physical Performance Battery (SPPB) and the De Morton Mobility Index (DEMMI) are two commonly used instruments to assess mobility in older patients.
Aims
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.
Methods
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.
Results
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.

Abstract

Background
The Short Physical Performance Battery (SPPB) and the De Morton Mobility Index (DEMMI) are two commonly used instruments to assess mobility in older patients.
Aims
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.
Methods
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.
Results
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.

Statistics

Citations

Altmetrics

Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Geriatric Medicine
Dewey Decimal Classification:610 Medicine & health
Scopus Subject Areas:Life Sciences > Aging
Health Sciences > Geriatrics and Gerontology
Uncontrolled Keywords:Ageing, Geriatrics and Gerontology
Language:English
Date:1 April 2020
Deposited On:18 Dec 2019 15:46
Last Modified:29 Jul 2020 11:58
Publisher:Springer
ISSN:1594-0667
OA Status:Closed
Publisher DOI:https://doi.org/10.1007/s40520-019-01249-9
PubMed ID:31286430

Download

Full text not available from this repository.
View at publisher

Get full-text in a library