Predictors of functional status in patients with a stroke or geriatric disease admitted to hospital

Abstract

Background: In the Netherlands, there are approximately two million hospitalizations every year. Many of these hospitalizations involve patients with a stroke or geriatric disease. A serious consequence of both these diseases is functional decline. Many factors that predict the functional status at discharge can be influenced by nursing care. However, there is little evidence about which factors at hospital admission predict the functional status at discharge in patients with a stroke or geriatric disease. It is important to obtain more evidence about these predictors in order to give directions for nursing interventions focusing on maintenance of functional status and prevention of functional decline. Aim: To identify which factors at hospital admission predict the functional status at discharge in patients with a stroke or geriatric disease. Methods: A prospective observational multicenter study. 122 patients were included. Demographic characteristics and predictors were collected at baseline. Functional status at discharge was operationalized as degree of independence in ADL and degree of mobility. Analyses were performed using multivariable linear regression. Results: The strongest predictor of the functional status at discharge is degree of independence in ADL at hospital admission. Furthermore, educational level, absence of communication skills, hearing impairments, vision impairments, and nutritional status are factors that predict the functional status at discharge. Kind of disease and presence of delirium are factors that only predict the degree of independence in ADL at discharge. Age, gender, marital status, presence of falls during the preceding six months, and number of medications are factors that only predict the degree of mobility at discharge. Conclusion and implications: This study identifies factors at hospital admission that predict the functional status at discharge in patients with a stroke or geriatric disease. These predictors give directions for nursing interventions focusing on maintenance of functional status and prevention of functional decline.