Measurement of dynamical resilience indicators improves the prediction of recovery following hospitalization in older adults

Sanne M.W. Gijzel, Jerrald Rector, Fokke B. van Meulen, Rolinka Schim van der Loeff, Ingrid A. van de Leemput, Marten Scheffer, Marcel G.M. Olde Rikkert, René J.F. Melis (Corresponding author)

Onderzoeksoutput: Bijdrage aan tijdschriftTijdschriftartikelAcademicpeer review

2 Citaten (Scopus)

Samenvatting

OBJECTIVES: Acute illnesses and subsequent hospital admissions present large health stressors to older adults, after which their recovery is variable. The concept of physical resilience offers opportunities to develop dynamical tools to predict an individual's recovery potential. This study aimed to investigate if dynamical resilience indicators based on repeated physical and mental measurements in acutely hospitalized geriatric patients have added value over single baseline measurements in predicting favorable recovery.

DESIGN: Intensive longitudinal study.

SETTING AND PARTICIPANTS: 121 patients (aged 84.3 ± 6.2 years, 60% female) admitted to the geriatric ward for acute illness.

MEASUREMENTS: In addition to preadmission characteristics (frailty, multimorbidity), in-hospital heart rate and physical activity were continuously monitored with a wearable sensor. Momentary well-being (life satisfaction, anxiety, discomfort) was measured by experience sampling 4 times per day. The added value of dynamical indicators of resilience was investigated for predicting recovery at hospital discharge and 3 months later.

RESULTS: 31% of participants satisfied the criteria of good recovery at hospital discharge and 50% after 3 months. A combination of a frailty index, multimorbidity, Clinical Frailty Scale, and or gait speed predicted good recovery reasonably well on the short term [area under the receiver operating characteristic curve (AUC) = 0.79], but only moderately after 3 months (AUC = 0.70). On addition of dynamical resilience indicators, the AUC for predicting good 3-month recovery increased to 0.79 (P = .03). Variability in life satisfaction and anxiety during the hospital stay were independent predictors of good 3-month recovery [odds ratio (OR) = 0.24, P = .01, and OR = 0.54, P = .04, respectively].

CONCLUSIONS AND IMPLICATIONS: These results highlight that measurements capturing the dynamic functioning of multiple physiological systems have added value in assessing physical resilience in clinical practice, especially those monitoring mental responses. Improved monitoring and prediction of physical resilience could help target intensive treatment options and subsequent geriatric rehabilitation to patients who will most likely benefit from them.

Originele taal-2Engels
Pagina's (van-tot)525-530.e4
Aantal pagina's10
TijdschriftJournal of the American Medical Directors Association
Volume21
Nummer van het tijdschrift4
Vroegere onlinedatum10 dec 2019
DOI's
StatusGepubliceerd - apr 2020

Bibliografische nota

Copyright © 2019 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

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