Functional decline in geriatric rehabilitation ward; is it ascribable to hospital acquired infection? A prospective coho
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RESEARCH ARTICLE
Open Access
Functional decline in geriatric rehabilitation ward; is it ascribable to hospital acquired infection? A prospective cohort study Marie Laurent1,2* , Nadia Oubaya1,3, Jean-Philippe David1,4, Cynthia Engels1,5, Florence Canoui-Poitrine1,3, Lola Corsin2, Eveline Liuu6, Etienne Audureau1,3, Sylvie Bastuji-Garin1,3† and Elena Paillaud1,7†
Abstract Background: In some European countries, including France, older patients with functional decline in acute units are transferred to geriatric rehabilitation units. Some patients may not benefit from their stay in a geriatric rehabilitation unit and paradoxically worsened their functional status. Previous prognostic models of functional decline are based on only baseline parameters. However, some events can occur during rehabilitation and modify the association between baseline parameters and rehabilitation performance such as heart failure episode, falls or hospital-acquired infection (HAI). The incidence of functional decline in these units and factors associated with this decline have not been clearly identified. Methods: We used a prospective cohort of consecutive patients aged ≥75 years admitted to a geriatric rehabilitation unit in a French university hospital. The main endpoint was functional decline defined by at least an one-point decrease in Activities of Daily Living (ADL) score during the stay. Baseline social and geriatric characteristics were recorded and comorbidities were sought by the Cumulative Illness Rating Scale for Geriatrics (CIRS-G). During follow-up, hospital-acquired infection (HAI) was recorded, as was ADL score at discharge. Multivariate logistic regression and mediation analyses were used to identify factors associated with ADL decrease. (Continued on next page)
* Correspondence: [email protected] † Sylvie Bastuji-Garin and Elena Paillaud contributed equally to this work. 1 Univ Paris Est Creteil, INSERM, IMRB, CEpiA Team, F-94010 Creteil, France 2 AP-HP, Hopital Henri Mondor, Departement de médecine interne et gériatrie, F-94010 Creteil, France Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedicati
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