Background: Patients spend about 95% of their hospitalization in bed, increasing the risk of functional decline associated with adverse events and readmissions. Some hospitals track patients’ functional mobility trends using Activity Measure for Post-Acute Care 6-Clicks Inpatient Short Form (AM-PAC). We aim to understand the associations between functional mobility loss from hospital admission to discharge, on delirium, falls risk, length of stay, discharge to a facility, and 30-day readmissions.

Methods: This is a retrospective cohort study with all adults admitted from 07/01/2021 to 06/06/2022 at an academic medical center in Northern California. Patients’ functional mobility during their hospitalization was assessed by nursing using the AM-PAC score difference between hospital admission and discharge Patients were sorted into three clinically significant categories based on AM-PAC scores: gain in mobility function (gain ≥3 AM-PAC points); no change (loss or gain of 0-2 AM-PAC points); and loss in mobility function (loss ≥3 AM-PAC points). Outcomes were assessed using the NuDeSc delirium screening tool, the stratify fall risk assessment tool and administrative data for length of stay, discharge location and 30-day readmission. We conducted a complete case analysis and multivariate logistic regression to assesses the association between functional mobility and outcomes.

Results: There were 15,897 patients with 20,950 encounters included in this study. Loss of mobility function was significantly associated with higher rates of delirium, higher falls risk, increased length of stay, and significantly more discharges to a facility but was not associated with 30-day readmissions (see Table 1).

Conclusions: Daily AM-PAC assessment may enable care teams to better prevent functional mobility loss and poor clinical and quality outcomes, but the applicability of this approach requires further research.

IMAGE 1: Table 1: Associations between loss in mobility function on clinical and quality outcomes