PMID: 8600192Mar 1, 1996Paper

Hospital admission risk profile (HARP): identifying older patients at risk for functional decline following acute medical illness and hospitalization

Journal of the American Geriatrics Society
M A SagerC H Winograd

Abstract

To develop and validate an instrument for stratifying older patients at the time of hospital admission according to their risk of developing new disabilities in activities of daily living (ADL) following acute medical illness and hospitalization. Multi-center prospective cohort study. Four university and two private non-federal acute care hospitals. The development cohort consists of 448 patients and the validation cohort consists of 379 patients who were aged 70 and older and who were hospitalized for acute medical illness between 1989 and 1992. All patients were evaluated on hospital admission to identify baseline demographic and functional characteristics and were then assessed at discharge and 3 months after discharge to determine decline in ADL functioning. Logistic regression analysis identified three patient characteristics that were independent predictors of functional decline in the development cohort: increasing age, lower admission Mini-Mental Status Exam scores, and lower preadmission IADL function. A scoring system was developed for each predictor variable and patients were assigned to low, intermediate, and high risk categories. The rates of ADL decline at discharge for the low, intermediate, and high risk categor...Continue Reading

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