Influence of Activities of Daily Living on Discharge Destination of Hospitalized Older Patients

Takuma Komatsu; Shingo Koyama; Hironobu Katata; Shotaro Sasaki; Yasuyuki Hatanaka; Takuma Mogamiya; Takahiro Shikenbaru; Yoshitsugu Omori; Masato Yamatoku; Nobuyuki Sasaki

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Influence of Activities of Daily Living on Discharge Destination of Hospitalized Older Patients

VernacularTitle:高齢内科疾患患者における日常生活活動能力が自宅退院の可否へ与える影響
Author: Takuma KOMATSU ¹ ; Shingo KOYAMA ² ; Hironobu KATATA ¹ ; Shotaro SASAKI ³ ; Yasuyuki HATANAKA ¹ ; Takuma MOGAMIYA ³ ; Takahiro SHIKENBARU ¹ ; Yoshitsugu OMORI ⁴ ; Masato YAMATOKU ⁵ ; Nobuyuki SASAKI ⁶
Author Information

1. Rehabilitation Center, St. Marianna University Hospital
2. Department of Rehabilitation, Juntendo Tokyo Koto Geriatric Medical Center
3. Rehabilitation Department, St. Marianna University Yokohama Seibu Hospital
4. Shonan University of Medical Sciences
5. Department of Neurology, St. Marianna University Hospital
6. Department of Rehabilitation Medicine, St. Marianna University Hospital
Keywords: older patients; patients with internal medical problems; activities of daily living; Barthel Index; home discharge
From:The Japanese Journal of Rehabilitation Medicine 2022;59(2):209-216
CountryJapan
Language:Japanese
Abstract: Objective：We analyzed whether activities of daily living (ADL) had an additive effect on the discharge destination of hospitalized older patients with internal medicine.Methods：Of the 691 patients hospitalized for medical illness aged 65 years or older who received physical therapy during this study period, 186 patients were included in the analysis. The main outcome was the discharge destination. Participants were categorized in the home discharge group and other institution group. The Barthel Index (BI) was used to assess the ADL at the first physical therapy session. Multivariate logistic regression analysis was used to estimate the influence of the BI on determining the discharge destination. The cut-off point of the BI score was evaluated using a receiver operating characteristic curve.Results：During the follow-up period, 17 participants (9.1%) could not be discharged to their homes. Logistic regression analysis showed that the BI influenced discharge destinations (odds ratio：1.54；95% confidence intervals：1.23-1.89). The cut-off point of the BI score for determining home discharge was 72.5 (sensitivity, 0.80；specificity, 0.94；area under the curve, 0.94；positive predictive value：0.99, negative predictive value：0.32).Conclusions：These findings suggest that the BI is a useful predictor for determining the potential destination of hospitalized older patients following discharge. However, the results of this study have limitations such as a low negative predictive value and a limited number of subjects.