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Validation of Screening Tools for Predicting the Risk of Functional Decline in Hospitalized Elderly Patients

Author

Listed:
  • Mei-Chun Wang

    (Department of Nursing, Kuang Tien General Hospital, Taichung 437021, Taiwan)

  • Wen-Chun Liao

    (School of Nursing, China Medical University, Taichung 406040, Taiwan
    Department of Nursing, China Medical University Hospital, Taichung 404332, Taiwan)

  • Kwo-Chen Lee

    (School of Nursing, China Medical University, Taichung 406040, Taiwan
    Department of Nursing, China Medical University Hospital, Taichung 404332, Taiwan)

  • Shu-Hua Lu

    (School of Nursing, China Medical University, Taichung 406040, Taiwan
    Department of Nursing, China Medical University Hospital, Taichung 404332, Taiwan)

  • Yun-Ping Lin

    (School of Nursing, China Medical University, Taichung 406040, Taiwan
    Department of Nursing, China Medical University Hospital, Taichung 404332, Taiwan)

Abstract

Background: Functional decline and increased dependence on others are common health issues among hospitalized elderly patients. However, a well-validated screening tool for predicting functional decline in elderly patients is still lacking. The current study therefore aimed to evaluate and compare the diagnostic accuracy of the Identification of Seniors at Risk—Hospitalized Patients (ISAR-HP), Variable Indicative of Placement Risk (VIP), and Score Hospitalier d’ Evaluation du Risque de Perte d’Autonomie (SHERPA) in predicting functional decline 30 days after discharge in older patients admitted to an acute hospital ward. Methods: A prospective, longitudinal study was conducted in 197 elderly inpatients at the internal medicine ward of a teaching hospital in central Taiwan. Data were collected twice, first within 48 h after hospitalization and second via a telephone interview 30 days after hospital discharge. Variables included demographic data, Barthel Index of activities of daily living (ADL), and screening instruments. The Barthel Index was used to measure functional disability. Functional decline was defined as a decline of at least five points on the Barthel Index 30 days after discharge compared to that at pre-admission. Results: Patients had a mean age of 77.7 years, with 55.7% being female. Functional decline was observed in 39.1% of all patients. The best cutoff point, sensitivity, specificity, and area under the receiver operating characteristic curve were 2.5, 96.1%, 52.5%, and 0.751 for ISAR-HP; 1.5, 83.1%, 62.5%, and 0.761 for VIP; and 4.75, 89.6%, 54.2%, and 0.758 for SHERPA, respectively. Conclusions: All three instruments showed moderate diagnostic accuracy as indicated by their best cutoff points. Therefore, the results presented herein can guide health care professionals in selecting the appropriate assessment tool for predicting functional decline among hospitalized elderly patients in a clinical setting.

Suggested Citation

  • Mei-Chun Wang & Wen-Chun Liao & Kwo-Chen Lee & Shu-Hua Lu & Yun-Ping Lin, 2022. "Validation of Screening Tools for Predicting the Risk of Functional Decline in Hospitalized Elderly Patients," IJERPH, MDPI, vol. 19(11), pages 1-9, May.
  • Handle: RePEc:gam:jijerp:v:19:y:2022:i:11:p:6685-:d:828019
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    References listed on IDEAS

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    1. Ann Pearman & Martha Storandt, 2005. "Self-Discipline and Self-Consciousness Predict Subjective Memory in Older Adults," The Journals of Gerontology: Series B, The Gerontological Society of America, vol. 60(3), pages 153-157.
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