Please use this identifier to cite or link to this item: https://doi.org/10.21256/zhaw-20157
Publication type: Article in scientific journal
Type of review: Peer review (publication)
Title: Association of functional status and hospital-acquired functional decline with 30-day outcomes in medical inpatients : a prospective cohort study
Authors: Koch, Daniel
Kutz, Alexander
Haubitz, Sebastian
Baechli, Ciril
Gregoriano, Claudia
Conca, Antoinette
Volken, Thomas
Schuetz, Philipp
Mueller, Beat
et. al: No
DOI: 10.1016/j.apnr.2020.151274
10.21256/zhaw-20157
Published in: Applied Nursing Research
Volume(Issue): 54
Issue: 151274
Issue Date: 2020
Publisher / Ed. Institution: Elsevier
ISSN: 0897-1897
1532-8201
Language: English
Subjects: Mortality; Readmission; Functional decline; Patient discharge; Institutionalization; Self-care
Subject (DDC): 610.73: Nursing
Abstract: Background: There is growing evidence that patients with functional decline are at increased risk of readmission, mortality and institutionalization. Instruments to measure the status of self-care could provide important information for efficient care planning. The widely used Self Care Index serves as an indicator for the severity of nursing dependency. To date, no evidence is available on the association of the instrument with rehospitalization, mortality and institutionalization. Objectives: To examine the association of functional status measures (Self Care Index on admission, at discharge and functional decline) with 30-day mortality, readmission and institutionalization in hospitalized non-surgical patients. Design: Prospective cohort study. Participants: We included 4540 emergency medical patients at a single hospital in Switzerland. Methods: Primary outcome was 30-day mortality rate; secondary outcomes were 30-day readmission and institutionalization. We analyzed the association of the functional status with the binary endpoints using logistic regression models and C-statistics for discrimination. Results: All of the examined measures were significant predictors of overall 30-day mortality; Self Care Index on admission: adj. OR: 0.90 (95% CI: 0.87–0.92); Self Care Index at discharge: adj. OR: 0.86 (95% CI: 0.83–0.88); functional decline: adj. OR: 1.22 (95% CI: 1.14–1.31) and all Self Care Index single items. A combined model (functional status on admission and functional decline during hospitalization) showed a good accuracy with regard to the AUC: adj. AUC: 0.80 (95% CI: 0.74–0.86). Conclusions: Several functional measures were associated with 30-day mortality. Self Care Index total score, five single items and a combined model showed the best performance.
URI: https://digitalcollection.zhaw.ch/handle/11475/20157
Fulltext version: Published version
License (according to publishing contract): CC BY-NC-ND 4.0: Attribution - Non commercial - No derivatives 4.0 International
Departement: School of Health Sciences
Organisational Unit: Institute of Public Health (IPH)
Appears in collections:Publikationen Gesundheit

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Koch, D., Kutz, A., Haubitz, S., Baechli, C., Gregoriano, C., Conca, A., Volken, T., Schuetz, P., & Mueller, B. (2020). Association of functional status and hospital-acquired functional decline with 30-day outcomes in medical inpatients : a prospective cohort study. Applied Nursing Research, 54(151274). https://doi.org/10.1016/j.apnr.2020.151274
Koch, D. et al. (2020) ‘Association of functional status and hospital-acquired functional decline with 30-day outcomes in medical inpatients : a prospective cohort study’, Applied Nursing Research, 54(151274). Available at: https://doi.org/10.1016/j.apnr.2020.151274.
D. Koch et al., “Association of functional status and hospital-acquired functional decline with 30-day outcomes in medical inpatients : a prospective cohort study,” Applied Nursing Research, vol. 54, no. 151274, 2020, doi: 10.1016/j.apnr.2020.151274.
KOCH, Daniel, Alexander KUTZ, Sebastian HAUBITZ, Ciril BAECHLI, Claudia GREGORIANO, Antoinette CONCA, Thomas VOLKEN, Philipp SCHUETZ und Beat MUELLER, 2020. Association of functional status and hospital-acquired functional decline with 30-day outcomes in medical inpatients : a prospective cohort study. Applied Nursing Research. 2020. Bd. 54, Nr. 151274. DOI 10.1016/j.apnr.2020.151274
Koch, Daniel, Alexander Kutz, Sebastian Haubitz, Ciril Baechli, Claudia Gregoriano, Antoinette Conca, Thomas Volken, Philipp Schuetz, and Beat Mueller. 2020. “Association of Functional Status and Hospital-Acquired Functional Decline with 30-Day Outcomes in Medical Inpatients : A Prospective Cohort Study.” Applied Nursing Research 54 (151274). https://doi.org/10.1016/j.apnr.2020.151274.
Koch, Daniel, et al. “Association of Functional Status and Hospital-Acquired Functional Decline with 30-Day Outcomes in Medical Inpatients : A Prospective Cohort Study.” Applied Nursing Research, vol. 54, no. 151274, 2020, https://doi.org/10.1016/j.apnr.2020.151274.


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