TY - JOUR
T1 - Influence of Prehospital Function and Strength on Outcomes of Critically Ill Older Adults
AU - Files, D. Clark
AU - Neiberg, Rebecca
AU - Rushing, Julia
AU - Morris, Peter E.
AU - Young, Michael P.
AU - Ayonayon, Hilsa
AU - Harris, Tamara
AU - Newman, Anne
AU - Rubin, Susan
AU - Shiroma, Eric
AU - Houston, Denise
AU - Miller, Michael E.
AU - Kritchevsky, Stephen B.
N1 - Publisher Copyright:
© 2018, Copyright the Authors Journal compilation © 2018, The American Geriatrics Society
PY - 2018/3
Y1 - 2018/3
N2 - Objectives: To understand the influence of prehospital physical function and strength on clinical outcomes of critically ill older adults. Design: Secondary analysis of prospective cohort study. Setting: Health, Aging and Body Composition (Health ABC) Study. Participants: Of 3,075 older adult Health ABC participants, we identified 575 (60% white, 61% male, mean age 79) with prehospital function or grip strength measurements within 2 years of an intensive care unit stay. Measurements: The primary analysis evaluated the association between prehospital walk speed and mortality, and secondary analyses focused on associations between function or grip strength and mortality or hospital length of stay. Function and grip strength were analyzed as continuous and categorical predictors. Results: Slower prehospital walk speed was associated with greater risk of 30-day mortality (for each 0.1 m/s slower, odds ratio = 1.13, 95% confidence interval (CI) = 1.04–1.23, P =.004). Grip strength, chair stands, and balance had weaker, non-statistically significant associations with 30-day mortality. Participants with slower prehospital walk speed (hazard ratio (HR) = 0.94, 95% CI = 0.90–0.98, P =.005) and weak grip strength (HR = 0.85, 95% CI = 0.73–0.99, P =.03) were less likely to be discharged from the hospital alive. All function and strength measures were significantly associated with 1-year mortality. Conclusion: Slow prehospital walk speed was strongly associated with greater 30-day mortality and longer hospital stay in critically ill older adults, and measures of function and strength were associated with 1-year mortality. These data add to the accumulating evidence on the relationship between physical function and critical care outcomes.
AB - Objectives: To understand the influence of prehospital physical function and strength on clinical outcomes of critically ill older adults. Design: Secondary analysis of prospective cohort study. Setting: Health, Aging and Body Composition (Health ABC) Study. Participants: Of 3,075 older adult Health ABC participants, we identified 575 (60% white, 61% male, mean age 79) with prehospital function or grip strength measurements within 2 years of an intensive care unit stay. Measurements: The primary analysis evaluated the association between prehospital walk speed and mortality, and secondary analyses focused on associations between function or grip strength and mortality or hospital length of stay. Function and grip strength were analyzed as continuous and categorical predictors. Results: Slower prehospital walk speed was associated with greater risk of 30-day mortality (for each 0.1 m/s slower, odds ratio = 1.13, 95% confidence interval (CI) = 1.04–1.23, P =.004). Grip strength, chair stands, and balance had weaker, non-statistically significant associations with 30-day mortality. Participants with slower prehospital walk speed (hazard ratio (HR) = 0.94, 95% CI = 0.90–0.98, P =.005) and weak grip strength (HR = 0.85, 95% CI = 0.73–0.99, P =.03) were less likely to be discharged from the hospital alive. All function and strength measures were significantly associated with 1-year mortality. Conclusion: Slow prehospital walk speed was strongly associated with greater 30-day mortality and longer hospital stay in critically ill older adults, and measures of function and strength were associated with 1-year mortality. These data add to the accumulating evidence on the relationship between physical function and critical care outcomes.
KW - aging
KW - critical care
KW - functional outcomes
KW - gait speed
KW - weakness
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U2 - 10.1111/jgs.15255
DO - 10.1111/jgs.15255
M3 - Article
C2 - 29322491
AN - SCOPUS:85040553813
SN - 0002-8614
VL - 66
SP - 525
EP - 531
JO - Journal of the American Geriatrics Society
JF - Journal of the American Geriatrics Society
IS - 3
ER -