Strength Relates to Discharge Disposition Among Hospitalized Older Adults

Introduction: This study investigated whether differences exist in lower extremity muscle strength among older adult patients discharged from acute care to different dispositions and whether lower extremity strength is associated with discharge disposition. Patient care teams collaborate to determine the appropriate discharge location for patients leaving acute care. One critical factor in patient success after hospital discharge is physical strength, yet lower extremity muscle strength is not currently prioritized during discharge. Subjects: We recruited 50 (33 female, 17 male) consenting patients aged 65 to 95 years admitted to a medical/surgical unit in a regional medical center in Texas. Methods: During physical therapy evaluations, we utilized a handheld dynamometer to measure bilateral hip flexion and knee extension strength. Demographic data, number of days to physical therapy referral, length of hospital stay, and discharge were recorded. Results: Results revealed significant differences between patients discharged to home (n = 35) versus inpatient therapy (n = 15) in 4 strength indicators, with patients discharged to home exhibiting greater muscle strength in right hip flexion ( P = .019), left hip flexion ( P = .037), right knee extension ( P = .020), and left knee extension ( P = .005). Length of hospital stay was significantly shorter for patients discharged to home ( P = .002). Finally, whether considering right knee extension ( P < .001) or left knee extension ( P < .001), knee extension strength and length of hospital stay were associated with the probability of discharging to home versus inpatient therapy. Discussion and Conclusions: We identified lower extremity muscle strength and length of hospital stay as factors that differ by discharge disposition and may be useful for discharge planning. This is the first study to demonstrate differences in lower extremity strength by discharge disposition in an older adult population. Incorporating lower extremity strength assessments into discharge-planning protocols could enhance decision-making processes, potentially improving functional post-hospitalization outcomes.