The influence of anemia on functional impairment and the Function Focused Care intervention.

Abstract

Background During hospital admissions, 35% of the older adults develop functional impairment. Functional impairment is more common in anemic patients. Evidence of the association between anemia and functional impairment in older orthopedic trauma patients is inconsistent. Function Focused Care for Acute Care (FFC-AC) is successful in reducing functional impairment. It is unknown if anemia influences this effect. Aims The purpose was to describe the association between anemia and functional impairment in post orthopedic trauma patients aged 65 years and over in acute care. The secondary objective was to investigate if FFC-AC was as effective in anemic as in non-anemic patients. Methods A secondary data-analysis was performed, using data from a RCT testing FFC-AC. Multiple regression was used to analyze the cross-sectional association between functional impairment and anemia. ANCOVA was used to assess the difference in the longitudinal effectiveness of FFC-AC between anemic and non-anemic patients. Results The sample included 89 participants. The cross-sectional association was not significant(p.446), however the possible confounders tethering(p=.002) and depression(p=.035) were. The ANCOVA based on N=31, showed no difference between the groups(p=.824). Conclusion Anemia has no significant association with functional impairment and FFC-AC seems as effective in older anemic as in non-anemic post orthopedic trauma patients. Recommendations Future research has to focus on the cross-sectional association between mild anemia and functional impairment, because another study shows a significant association in patients with severe anemia. Similar to other studies, the longitudinal association was not significant, which support the use of FFC-AC anemic patients but further research is needed because of the small sample. To prevent functional impairment, it is recommended to limit the use of tethers, duration of tether use and screen for depression on admission.