Activity Measure for Post-Acute Care "6-Clicks" for the Prediction of Short-term Clinical Outcomes in Individuals Hospitalized With COVID-19: A Retrospective Cohort Study.
Arch Phys Med Rehabil
; 102(12): 2300-2308.e3, 2021 12.
Article
in English
| MEDLINE | ID: covidwho-1460613
ABSTRACT
OBJECTIVE:
To determine the ability of the Activity Measure for Post-Acute Care (AM-PAC) "6-Clicks" assessments of mobility and activity to predict key clinical outcomes in patients hospitalized with coronavirus disease 2019 (COVID-19).DESIGN:
Retrospective cohort study.SETTING:
An academic health system in the United States consisting of 5 inpatient hospitals.PARTICIPANTS:
Adult patients (N=1486) urgently or emergently admitted who tested positive for COVID-19 and had at least 1 AM-PAC assessment.INTERVENTIONS:
Not applicable. MAIN OUTCOMEMEASURES:
Discharge destination, hospital length of stay, in-hospital mortality, and readmission.RESULTS:
A total of 1486 admission records were included in the analysis. After controlling for covariates, initial and final mobility (odds ratio, 0.867 and 0.833, respectively) and activity scores (odds ratio, 0.892 and 0.862, respectively) were both independent predictors of discharge destination with a high accuracy of prediction (area under the curve [AUC]=0.819-0.847). Using a threshold score of 17.5, sensitivity ranged from 0.72-0.79, whereas specificity ranged from 0.74-0.83. Both initial AM-PAC mobility and activity scores were independent predictors of mortality (odds ratio, 0.885 and 0.877, respectively). Initial mobility, but not activity, scores were predictive of prolonged length of stay (odds ratio, 0.957 and 0.980, respectively). However, the accuracy of prediction for both outcomes was weak (AUC=0.659-0.679). AM-PAC scores did not predict rehospitalization.CONCLUSIONS:
Functional status as measured by the AM-PAC "6-Clicks" mobility and activity scores are independent predictors of key clinical outcomes individual hospitalized with COVID-19.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Patient Discharge
/
Outcome Assessment, Health Care
/
COVID-19
/
Hospitalization
/
Length of Stay
Type of study:
Cohort study
/
Observational study
/
Prognostic study
Topics:
Long Covid
Limits:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Country/Region as subject:
North America
Language:
English
Journal:
Arch Phys Med Rehabil
Year:
2021
Document Type:
Article
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