Reichardt Lucienne A, Aarden Jesse J, van Seben Rosanne, van der Schaaf Marike, Engelbert Raoul H H, Bosch Jos A, Buurman Bianca M
Department of Internal Medicine, Section of Geriatric Medicine, Academic Medical Center, PO Box 22600, 1100 DD, Amsterdam, The Netherlands.
Department of Rehabilitation, Academic Medical Center, Amsterdam, The Netherlands.
BMC Geriatr. 2016 Mar 5;16:59. doi: 10.1186/s12877-016-0232-3.
Over 30 % of older patients experience hospitalization-associated disability (HAD) (i.e., loss of independence in Activities of Daily Living (ADLs)) after an acute hospitalization. Despite its high prevalence, the mechanisms that underlie HAD remain elusive. This paper describes the protocol for the Hospital-Associated Disability and impact on daily Life (Hospital-ADL) study, which aims to unravel the potential mechanisms behind HAD from admission to three months post-discharge.
METHODS/DESIGN: The Hospital-ADL study is a multicenter, observational, prospective cohort study aiming to recruit 400 patients aged ≥70 years that are acutely hospitalized at departments of Internal Medicine, Cardiology or Geriatrics, involving six hospitals in the Netherlands. Eligible are patients hospitalized for at least 48 h, without major cognitive impairment (Mini Mental State Examination score ≥15), who have a life expectancy of more than three months, and without disablement in all six ADLs. The study will assess possible cognitive, behavioral, psychosocial, physical, and biological factors of HAD. Data will be collected through: 1] medical and demographical data; 2] personal interviews, which includes assessment of cognitive impairment, behavioral and psychosocial functioning, physical functioning, and health care utilization; 3] physical performance tests, which includes gait speed, hand grip strength, balance, bioelectrical impedance analysis (BIA), and an activity tracker (Fitbit Flex), and; 4] analyses of blood samples to assess inflammatory and metabolic markers. The primary endpoint is additional disabilities in ADLs three months post-hospital discharge compared to ADL function two weeks prior to hospital admission. Secondary outcomes are health care utilization, health-related quality of life (HRQoL), physical performance tests, and mortality. There will be at least five data collection points; within 48 h after admission (H1), at discharge (H3), and at one (P1; home visit), two (P2; by telephone) and three months (P3; home visit) post-discharge. If the patient is admitted for more than five days, additional measurements will be planned during hospitalization on Monday, Wednesday, and Friday (H2).
The Hospital-ADL study will provide information on cognitive, behavioral, psychosocial, physical, and biological factors associated with HAD and will be collected during and following hospitalization. These data may inform new interventions to prevent or restore hospitalization-associated disability.
超过30%的老年患者在急性住院后会出现与住院相关的残疾（HAD）（即日常生活活动（ADL）能力丧失）。尽管其患病率很高，但HAD背后的机制仍不清楚。本文描述了“与住院相关的残疾及其对日常生活的影响（Hospital-ADL）研究”的方案，该研究旨在揭示从入院到出院后三个月HAD背后的潜在机制。
方法/设计：Hospital-ADL研究是一项多中心、观察性、前瞻性队列研究，旨在招募400名年龄≥70岁、在内科、心脏病科或老年病科急性住院的患者，涉及荷兰的六家医院。符合条件的患者需住院至少48小时，无严重认知障碍（简易精神状态检查表得分≥15），预期寿命超过三个月，且六项ADL均无残疾。该研究将评估HAD可能的认知、行为、心理社会、身体和生物学因素。数据将通过以下方式收集：1]医疗和人口统计学数据；2]个人访谈，包括对认知障碍、行为和心理社会功能、身体功能以及医疗保健利用情况的评估；3]身体性能测试，包括步速、握力、平衡、生物电阻抗分析（BIA）和活动追踪器（Fitbit Flex），以及；4]血液样本分析以评估炎症和代谢标志物。主要终点是出院后三个月与入院前两周相比ADL功能的额外残疾情况。次要结局包括医疗保健利用情况、健康相关生活质量（HRQoL）、身体性能测试和死亡率。将至少有五个数据收集点；入院后48小时内（H1）、出院时（H3）以及出院后1个月（P1；家访）、2个月（P2；电话随访）和3个月（P3；家访）。如果患者住院超过五天，将计划在住院期间的周一、周三和周五进行额外测量（H2）。
Hospital-ADL研究将提供与HAD相关的认知、行为、心理社会、身体和生物学因素的信息，并将在住院期间及出院后收集。这些数据可能为预防或恢复与住院相关的残疾的新干预措施提供依据。
