Background. Decline in physical function is common in older persons admitted to the hospital. Furthermore, in older people hemoglobin levels are associated with poor physical performance and disability, but scant data are available for hospitalized patients. We evaluated the cross sectional and longitudinal association between hemoglobin levels and objective measures of physical performance in older hospitalized patients. Methods. Ninety two patients aged 65 admitted to the hospital for a medical event were enrolled. Inclusion criteria were ability to walk across a small room and absence of severe cognitive impairment (MMSE>18). Hemoglobin levels were assessed at hospital admission; anemia was defined according to WHO criteria. Lower-extremities performance was evaluated at hospital admission and at discharge using the Short Physical Performance Battery (SPPB), including standing balance, 4-meter walk, and five repetitive chair stands. Results. Mean age was 78 years; 49% were women and anemia prevalence was 47.8% (44.4% for women and 51% for men, respectively). Lower hemoglobin levels were associated with lower SPPB score at baseline (r:.24; p=0.042) and with greater decline in SPPB during hospitalization (p=0.006). This finding was still significant after adjustment for age, gender, MMSE, comorbidity and ADL disability (beta: 0.24; P =0.042). Additionally, after multiple adjustments and compared to patients with normal hemoglobin levels, patients with anemia had a four-fold risk of SPPB decline during hospitalization (O.R.: 4.0; 95% C.I.: 1.0-14.9). Conclusions. In older hospitalized patients, hemoglobin level is an independent risk factor for functional decline. The effect of anemia treatment on functional status remained to be determined.
Hemoglobin levels predict functional change during hospitalization in older patients
VOLPATO, Stefano;SIOULIS, Fotini;CAVALIERI, Margherita;MARALDI, Cinzia;FELLIN, Renato
2008
Abstract
Background. Decline in physical function is common in older persons admitted to the hospital. Furthermore, in older people hemoglobin levels are associated with poor physical performance and disability, but scant data are available for hospitalized patients. We evaluated the cross sectional and longitudinal association between hemoglobin levels and objective measures of physical performance in older hospitalized patients. Methods. Ninety two patients aged 65 admitted to the hospital for a medical event were enrolled. Inclusion criteria were ability to walk across a small room and absence of severe cognitive impairment (MMSE>18). Hemoglobin levels were assessed at hospital admission; anemia was defined according to WHO criteria. Lower-extremities performance was evaluated at hospital admission and at discharge using the Short Physical Performance Battery (SPPB), including standing balance, 4-meter walk, and five repetitive chair stands. Results. Mean age was 78 years; 49% were women and anemia prevalence was 47.8% (44.4% for women and 51% for men, respectively). Lower hemoglobin levels were associated with lower SPPB score at baseline (r:.24; p=0.042) and with greater decline in SPPB during hospitalization (p=0.006). This finding was still significant after adjustment for age, gender, MMSE, comorbidity and ADL disability (beta: 0.24; P =0.042). Additionally, after multiple adjustments and compared to patients with normal hemoglobin levels, patients with anemia had a four-fold risk of SPPB decline during hospitalization (O.R.: 4.0; 95% C.I.: 1.0-14.9). Conclusions. In older hospitalized patients, hemoglobin level is an independent risk factor for functional decline. The effect of anemia treatment on functional status remained to be determined.I documenti in SFERA sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
