Risk Factors for the Impairment of Ambulation in Older People Hospitalized with COVID-19: A Retrospective Cohort Study
Abstract
:1. Introduction
2. Materials and Methods
- i.
- Independent ambulator: Individual can ambulate independently on flat or uneven surfaces, stairs, and uneven slopes. This classification includes the categories “independent ambulator only on a flat surface” and “independent ambulator”.
- ii.
- Dependent ambulator: Individual requires manual contact with, at most, one person while ambulating on level surfaces in order to prevent falls; manual contact consists of continuous or intermittent touch to aid balance or coordination. This classification includes the categories “level III physical assistance-dependent ambulator” and “level I physical assistance-dependent ambulator and supervision-dependent ambulator”.
- iii.
- Nonfunctional ambulator: Requires maximum help, with the need for assistive technology.
Data Analysis
3. Results
3.1. Older People Hospitalized with COVID-19
3.2. Ambulation Capacity at Hospital Discharge
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Sociodemographic and Clinical Characteristics | Ability to Walk before Hospital Admission | |||||
---|---|---|---|---|---|---|
Independent Ambulator n = 289 (67.4%) | Dependent Ambulator n = 68 (15.8%) | Non-Functional Ambulator n = 72 (16.8%) | Total n = 429 (100%) | p(χ2) | ||
Age (years) | 60–69 | 172 (69.9) | 32 (13.0) | 42 (17.1) | 246 | 0.046 |
70–79 | 95 (68.8) | 24 (17.4) | 19 (13.8) | 138 | ||
80 or older | 22 (48.9) | 12 (26.7) | 11 (24.4) | 45 | ||
Sex | Female | 113 (66.1) | 27 (15.8) | 31 (18.1) | 171 | 0.828 |
Male | 176 (66.2) | 41 (15.9) | 41 (15.9) | 258 | ||
Race | White | 91 (52.3) | 20 (13.7) | 35 (24.0) | 146 | 0.015 |
Brown | 88 (64.7) | 26 (19.1) | 22 (16.2) | 139 | ||
Black | 108 (75.5) | 21 (14.7) | 14 (9.8) | 143 | ||
Habits | Tobacco | 62 (67.5) | 12 (15.2) | 5 (6.3) | 79 | 0.016 |
Alcoholic Beverage | 8 (72.7) | 2 (18.2) | 1 (9.1) | 11 | 0.782 | |
Comorbidity | Immunosuppression | 30 (69.8) | 9 (20.9) | 4 (9.3) | 43 | 0.299 |
Hematologic | 3 (75.0) | 1 (25.0) | - | 4 | 0.629 | |
Neurologic | 10 (41.7) | 8 (33.3) | 6 (25.0) | 24 | 0.015 | |
Pulmonary | 20 (65.3) | 5 (17.9) | 5 (16.8) | 30 | 0.992 | |
Cardiovascular | 62 (63.26) | 17 (17.35) | 16 (19.39) | 95 | 0.818 | |
Renal | 8 (80.0) | 2 (20.0) | - | 10 | 0.355 | |
Hepatic | 4 (80.0) | 1 (20.0) | - | 5 | 0.599 | |
Systemic Arterial Hypertension | 153 (67.7) | 40 (17.7) | 33 (14.6) | 226 | 0.302 | |
Diabetes Mellitus | 111 (70.3) | 29 (18.3) | 18 (11.4) | 158 | 0.060 | |
Obesity | 49 (68.1) | 15 (20.8) | 8 (11.1) | 72 | 0.221 | |
Dyslipidemia | 37 (77.1) | 6 (12.5) | 5 (10.4) | 48 | 0.190 | |
Hospitalization (>20 days) | 118 (66.3) | 36 (22.2) | 24 (13.5) | 178 | 0.059 | |
Intensive care unit (>11 days) | 135 (65.2) | 38 (18.4) | 34 (16.4) | 207 | 0.332 | |
Invasive mechanical ventilation | 265 (65.59) | 57 (14.11) | 82 (20.30) | 404 | 0.001 | |
In-hospital death | 106 (64.17) | 31 (13.37) | 50 (22.46) | 187 | 0.684 ˂0.001 | |
COVID-19 wave | 1st | 107 (59.1) | 22 (12.2) | 52 (28.7) | 181 | |
2nd | 182 (73.4) | 46 (18.5) | 20 (8.1) | 248 | ˂0.001 |
Ability to Walk before Hospitalization | In-Hospital Death n = 187 (43.6%) | At Hospital Discharge n = 252 (57.4%) | Total | ||
---|---|---|---|---|---|
Same Ambulation Capacity n = 102 (23.81%) | Worse Ambulation Capacity n = 140 (32.6%) | n = 429 | p | ||
Independent Ambulator (n = 289) | 106 (24.7) | 78 (18.2) | 105 (24.5) | 289 (67.4) | <0.001 χ2 |
Dependent Ambulator (n = 68) | 31 (7.2) | 2 (0.5) | 35 (8.2) | 68 (15.9) | |
Non-Functional Ambulator (n = 72) | 50 (11.7) | 22 (5.1) | -- | 72 (16.8) |
Demographic and Clinical Characteristics | Ambulation Capacity at Hospital Discharge | ||||
---|---|---|---|---|---|
Same n = 102 (42.1%) | Worse n = 140 (57.9%) | OR (CI95%) | p | ||
Age (years) | 60–69 | 61 (42.9) | 81 (57.1) | Ref | |
70–79 | 35 (44.3) | 44 (55.7) | 1.0 (0.5–1.6) | 0.847 | |
80 years or older | 6 (28.6) | 15 (71.4) | 1.8 (0.7–5.1) | 0.217 | |
Sex | Female | 57 (50.0) | 57 (50.0) | Ref | |
Male | 45 (35.2) | 83 (64.8) | 1.8 (1.1–3.1) | 0.020 | |
Color/Race | White | 47 (58.8) | 33 (41.2) | Ref | |
Brown | 27 (33.3) | 54 (66.7) | 2.8 (1.5–5.4) | 0.001 | |
Black | 27 (34.6) | 51 (65.4) | 2.7 (1.4–5.1) | 0.003 | |
Habits | Tobacco | 13 (30.9) | 29 (69.1) | 1.7 (0.8–3.5) | 0.124 |
Alcoholic beverage | – | 4 (100.0) | --- | --- | |
Comorbidities | Immunosuppression | 9 (36.0) | 16 (64.0) | 1.3 (0.6–3.1) | 0.512 |
Hematologic | 1 (50.0) | 1 (50.0) | 0.7 (0.1–11.7) | 0.822 | |
Neurologic | 3 (721.4) | 11 (78.6) | 2.8 (0.7–10.3) | 0.120 | |
Pulmonary | 9 (56.3) | 7 (43.7) | 0.5 (0.2–1.5) | 0.243 | |
Cardiovascular | 29 (46.0) | 34 (54.0) | 0.8 (0.4–1.4) | 0.468 | |
Renal | 2 (33.3) | 4 (66.7) | 1.5 (0.3–8.2) | 0.660 | |
Hepatic | 1 (33.3) | 2 (66.7) | 1.4 (0.1–16.3) | 0.757 | |
Systemic Arterial Hypertension | 62 (44.9) | 76 (55.1) | 0.7 (0.4–1.3) | 0.314 | |
Diabetes Mellitus | 42 (42.4) | 57 (57.6) | 1.0 (0.6–1.6) | 0.942 | |
Obesity | 12 (30.8) | 27 (69.2) | 1.8 (0.8–3.7) | 0.119 | |
Dyslipidemia | 4 (19.1) | 17 (80.9) | 3.4 (1.1–10.4) | 0.033 | |
Hospitalization (>20 days) | 32 (28.3) | 81 (71.7) | 2.9 (1.7–5.0) | <0.001 | |
Intensive care unit (>11 days) | 29 (19.0) | 71 (71.0) | 1.9 (1.1–3.4) | 0.027 | |
Invasive mechanical ventilation | 91 (43.1) | 120 (56.9) | 0.6 (0.3–1.5) | 0.211 | |
Ambulation capacity before COVID-19 | Independent Ambulator | 78 (42.6) | 105 (57.4) | Ref | |
Dependent Ambulator | 2 (5.4) | 35 (94.6) | 13.0 (3.0–55.6) | 0.001 | |
2nd wave | 28 (26.4) | 106 (73.6) | 5.2 (3.0–9.1) | <0.001 |
Demographic and Clinical Characteristics | Ambulation Capacity at Hospital Discharge | ||
---|---|---|---|
OR (CI95%) | p | ||
Sex | Male | 1.7 (0.9–3.6) | 0.114 |
Color/Race | White | Ref | |
Brown | 1.7 (0.7–4.4) | 0.203 | |
Black | 1.1 (0.4–2.7) | 0.925 | |
Tobacco Use | 0.7 (0.3–1.9) | 0.603 | |
Obesity | 1.2 (0.4–3.4) | 0.770 | |
Dyslipidemia | 1.3 (0.3–5.6) | 0.741 | |
Neurological Diseases | 3.8 (0.3–46.9) | 0.293 | |
Hospitalization > 20 days | 3.5 (1.7–7.3) | 0.001 | |
Ambulation capacity before hospital admission | Independent Ambulator | Ref | |
Dependent Ambulator | 11.3 (1.4–52.7) | 0.002 | |
2nd wave | 4.8 (2.1–11.1) | <0.001 |
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Silva, E.C.G.e.; Schmitt, A.C.B.; de Godoy, C.G.; de Oliveira, D.B.; Tanaka, C.; Toufen, C., Jr.; de Carvalho, C.R.R.; Carvalho, C.R.F.; Fu, C.; Hill, K.D.; et al. Risk Factors for the Impairment of Ambulation in Older People Hospitalized with COVID-19: A Retrospective Cohort Study. Int. J. Environ. Res. Public Health 2023, 20, 7057. https://doi.org/10.3390/ijerph20227057
Silva ECGe, Schmitt ACB, de Godoy CG, de Oliveira DB, Tanaka C, Toufen C Jr., de Carvalho CRR, Carvalho CRF, Fu C, Hill KD, et al. Risk Factors for the Impairment of Ambulation in Older People Hospitalized with COVID-19: A Retrospective Cohort Study. International Journal of Environmental Research and Public Health. 2023; 20(22):7057. https://doi.org/10.3390/ijerph20227057
Chicago/Turabian StyleSilva, Erika Christina Gouveia e, Ana Carolina Basso Schmitt, Caroline Gil de Godoy, Danielle Brancolini de Oliveira, Clarice Tanaka, Carlos Toufen, Jr., Carlos Roberto Ribeiro de Carvalho, Celso R. F. Carvalho, Carolina Fu, Keith D. Hill, and et al. 2023. "Risk Factors for the Impairment of Ambulation in Older People Hospitalized with COVID-19: A Retrospective Cohort Study" International Journal of Environmental Research and Public Health 20, no. 22: 7057. https://doi.org/10.3390/ijerph20227057
APA StyleSilva, E. C. G. e., Schmitt, A. C. B., de Godoy, C. G., de Oliveira, D. B., Tanaka, C., Toufen, C., Jr., de Carvalho, C. R. R., Carvalho, C. R. F., Fu, C., Hill, K. D., & Pompeu, J. E. (2023). Risk Factors for the Impairment of Ambulation in Older People Hospitalized with COVID-19: A Retrospective Cohort Study. International Journal of Environmental Research and Public Health, 20(22), 7057. https://doi.org/10.3390/ijerph20227057