Abstract
Objective
To assess the predictive capabilities of 2 measures of functional mobility, the 6-clicks
score and the Braden scale mobility score. We also identified the additional predictive
value of adding electronic health record data (demographics, laboratory data, and
vital signs) to each model.
Design
Cohort study.
Setting
A large integrated health system.
Participants
Patients ≥18 years of age (N=17,022) admitted to the inpatient medical service of
one of 8 hospitals.
Interventions
None.
Main Outcome Measures
Predictive measures were patient demographics, laboratory values, vital signs, and
functional mobility as measured by the 6-clicks score within the first 48 hours of
hospital admission. Our outcome was discharge destination (home vs other).
Results
Our final sample included 19,963 records. Patients were discharged alive from 19,698
admissions. The majority were women (n=11,729, 59%) with a mean age of 73 (standard
deviation, 15.3) years. Patients’ initial 6-clicks score had moderate discrimination
for discharge destination (c-statistic of 0.78) and outperformed the Braden score
(c-statistic of 0.68). Electronic health record data alone had poor discrimination
(c-statistic of 0.66) and added little to the model of 6-clicks alone (adjusted c-statistic
increased from 0.78 to 0.80).
Conclusion
Functional mobility measured via 6-clicks within 48 hours of admission can help identify
patients who are likely to go home, facilitating early discharge planning.
Keywords
List of abbreviations:
AM-PAC (Activity Measure for Post-Acute Care), HER (electronic health record)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: April 06, 2020
Footnotes
Disclosures: Mary Stilphen is a consultant for Cre Care, the company that licenses AM-PAC short forms. The other authors have nothing to disclose.
Identification
Copyright
© 2020 by the American Congress of Rehabilitation Medicine
