Gait speed, muscle strength, and functional status predict 30-day unplanned hospital readmission of critical care survivors

Background and Purpose: Despite intense efforts, predicting hospital readmission risks remains an imprecise task. Growing evidence suggests that unmeasured patient-related factors, such as functional impairment, seem to be strongly associated with acute readmission and have yet to be extensively explored. We hypothesized that gait speed, hand grip strength, and the Functional independence measure (FIM) might be associated with acute rehospitalization rates after an ICU stay.Methods: In our study, we assessed gait speed using a 10-m walk test. Muscle strength was determined by a hydraulic handgrip dynamometer and functional status through the FIM. Our primary outcome was the cumulative incidence of the first unplanned early rehospitalization (occurring within 30 days of hospital discharge) for the entire cohort, and a Receiver Operator Characteristic (ROC) analysis was used to determine the accuracy of gait speed, handgrip strength, and FIM domains in predicting hospital readmission.Results: ROC analysis indicated that the gait speed (AUC 0.96 95% CI 0.93 to 0.99), FIM score (AUC 0.96 95% CI 0.94 to 0.99) and handgrip strength (0.85 95% CI 0.76 to 0.94) were considered accurate predictors of unplanned readmission in the population studied. Additionally, we found that each 0.1 m/s lower gait speed was associated with a 10% higher odd of unplanned readmissions.Conclusion: Hence, our results suggest gait speed, handgrip strength and functional status demonstrated high potential to contribute to the determination of 30-day unplanned hospital readmission prediction of critical care survivors.

Automated summary

This study found that gait speed, handgrip strength, and functional independence measure are strongly associated with acute readmission rates after ICU stay. These measures accurately predict unplanned readmission within 30 days, with each 0.1 m/s lower gait speed increasing the odds of readmission by 10%.