Predictors of Functional Improvement During Comprehensive Geriatric Care in Germany: A 10-Year Monocentric Retrospective Analysis

德国综合老年护理期间功能改善的预测因素:一项为期10年的单中心回顾性分析

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Abstract

INTRODUCTION: Functional decline is a common risk among hospitalized older adults. Comprehensive Geriatric Care (CGC) has been shown to improve clinical outcomes in this population. However, beneficial predictors are not fully known. METHODS: This study was conducted at the Department of Geriatrics, University Hospital Jena, Germany. Data were collected from 2014 to 2023. Functional improvement was defined as a positive change in the Barthel Index from admission to discharge. Covariates included age, sex, body mass index (BMI), number of functional disabilities (Lachs screening), cognition, depressive symptoms, mobility, and treatment duration. Statistical analyses were conducted using binominal logistic regression to identify predictors of functional improvement. RESULTS: Of 3,990 patients, functional improvement was observed in 85.2%, which was associated with female sex (OR = 1.352; p = .007), fewer functional disabilities (OR = 0.905; p = .007), better cognition (OR = 1.130; p < .001), better mobility (OR = 1.114; p < .001), lower Barthel Index at admission (OR = 0.964; p < .001), and longer treatment duration (OR = 1.987; p < .001; χ(2)(6) = 181.32, p < .001, Nagelkerke's R (2) = 0.104). No significant associations were found for age, BMI, or depressive symptoms. CONCLUSION: Most patients experienced a functional improvement during CGC. However, commonly used predictors explain only a small proportion of the variance, suggesting that additional biopsychosocial factors need to be explored to better predict outcomes after CGC.

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