Functional Assessment of >18 Years Old Patients at Internal Medicine Ward—Relationship with In-Hospital and 30-Day Mortality

Objective: To evaluate the connection between the items included in the AVD-DezIs score (a questionnaire about basic and instrumental activities of daily living and other topics related to social and personal life) and in-hospital and 30-day mortality after discharge. Methods: Prospective cohort stu...

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Main Authors: Heloísa Ribeiro, Yolanda Martins, Isabel Natário, Luís Pedro Tavares
Format: Article
Language:English
Published: Elsevier 2024-12-01
Series:American Journal of Medicine Open
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Online Access:http://www.sciencedirect.com/science/article/pii/S2667036424000116
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author Heloísa Ribeiro
Yolanda Martins
Isabel Natário
Luís Pedro Tavares
author_facet Heloísa Ribeiro
Yolanda Martins
Isabel Natário
Luís Pedro Tavares
author_sort Heloísa Ribeiro
collection DOAJ
description Objective: To evaluate the connection between the items included in the AVD-DezIs score (a questionnaire about basic and instrumental activities of daily living and other topics related to social and personal life) and in-hospital and 30-day mortality after discharge. Methods: Prospective cohort study of hospitalizations in the Internal Medicine ward from 2014 to 2020, including >18 years old patients with a fully completed AVD-DezIs. To identify in-hospital and 30 days mortality, univariate and multivariate logistic models were applied, including random effects if justified. Results: A total of 19,771 episodes of hospitalization were included. In the univariate analysis, except for the presence of isolation and financial insufficiency, all the items were predictors of mortality in-hospital or within 30 days after discharge. In multivariate analysis, older age, male sex, longer hospital stay, higher Charlson score, deficiency in all four activities of daily living, deficiency in meal preparation and housekeeping, presence of pain/depression, immobility, and malnutrition are associated with a higher probability of in-hospital death whereas older age, male gender, higher Charlson score, longer length of hospital stay, deficiency in personal hygiene, ambulation, and eating habits, as well as the presence of incontinence and malnutrition, are associated with a higher probability of 30 days after discharge death. Discussion/Conclusion: Except for isolation and financial insufficiency, all items were individually associated with the outcomes. When they are considered in conjunction and taking into account sex, age, comorbidities and length of stay, the predictive ability of in-hospital and 30 days mortality differed.
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spelling doaj-art-aed49b4dc5e74798bbe91d93cd9374302025-08-20T02:50:27ZengElsevierAmerican Journal of Medicine Open2667-03642024-12-011210007410.1016/j.ajmo.2024.100074Functional Assessment of >18 Years Old Patients at Internal Medicine Ward—Relationship with In-Hospital and 30-Day MortalityHeloísa Ribeiro0Yolanda Martins1Isabel Natário2Luís Pedro Tavares3Serviço de Medicina Interna, Centro Hospitalar de Entre o Douro e Vouga, Santa Maria da Feira, Portugal; Requests for reprints should be addressed to Rua Dr. Cândido Pinho, 4520-220 Santa Maria da Feira, PortugalServiço de Medicina Interna, Centro Hospitalar de Entre o Douro e Vouga, Santa Maria da Feira, PortugalNOVA MATH & Department of Mathematics, NOVA School of Science and Technology, NOVA University of Lisbon, Lisboa, PortugalServiço de Medicina Interna, Centro Hospitalar de Entre o Douro e Vouga, Santa Maria da Feira, PortugalObjective: To evaluate the connection between the items included in the AVD-DezIs score (a questionnaire about basic and instrumental activities of daily living and other topics related to social and personal life) and in-hospital and 30-day mortality after discharge. Methods: Prospective cohort study of hospitalizations in the Internal Medicine ward from 2014 to 2020, including >18 years old patients with a fully completed AVD-DezIs. To identify in-hospital and 30 days mortality, univariate and multivariate logistic models were applied, including random effects if justified. Results: A total of 19,771 episodes of hospitalization were included. In the univariate analysis, except for the presence of isolation and financial insufficiency, all the items were predictors of mortality in-hospital or within 30 days after discharge. In multivariate analysis, older age, male sex, longer hospital stay, higher Charlson score, deficiency in all four activities of daily living, deficiency in meal preparation and housekeeping, presence of pain/depression, immobility, and malnutrition are associated with a higher probability of in-hospital death whereas older age, male gender, higher Charlson score, longer length of hospital stay, deficiency in personal hygiene, ambulation, and eating habits, as well as the presence of incontinence and malnutrition, are associated with a higher probability of 30 days after discharge death. Discussion/Conclusion: Except for isolation and financial insufficiency, all items were individually associated with the outcomes. When they are considered in conjunction and taking into account sex, age, comorbidities and length of stay, the predictive ability of in-hospital and 30 days mortality differed.http://www.sciencedirect.com/science/article/pii/S2667036424000116Activities of daily livingMortalityIn-hospital deathHospitalizations
spellingShingle Heloísa Ribeiro
Yolanda Martins
Isabel Natário
Luís Pedro Tavares
Functional Assessment of >18 Years Old Patients at Internal Medicine Ward—Relationship with In-Hospital and 30-Day Mortality
American Journal of Medicine Open
Activities of daily living
Mortality
In-hospital death
Hospitalizations
title Functional Assessment of >18 Years Old Patients at Internal Medicine Ward—Relationship with In-Hospital and 30-Day Mortality
title_full Functional Assessment of >18 Years Old Patients at Internal Medicine Ward—Relationship with In-Hospital and 30-Day Mortality
title_fullStr Functional Assessment of >18 Years Old Patients at Internal Medicine Ward—Relationship with In-Hospital and 30-Day Mortality
title_full_unstemmed Functional Assessment of >18 Years Old Patients at Internal Medicine Ward—Relationship with In-Hospital and 30-Day Mortality
title_short Functional Assessment of >18 Years Old Patients at Internal Medicine Ward—Relationship with In-Hospital and 30-Day Mortality
title_sort functional assessment of 18 years old patients at internal medicine ward relationship with in hospital and 30 day mortality
topic Activities of daily living
Mortality
In-hospital death
Hospitalizations
url http://www.sciencedirect.com/science/article/pii/S2667036424000116
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