medRxiv · Nov 2, 2025
Establishment and Quality Assessment of a Hospital-Associated Disability Database in Japan
By Hori S, Wakabayashi H, Nishioka S et al.
Abstract Objectives Hospital-associated disability (HAD) refers to a decline in activities of daily living (ADL) during hospitalization and is associated with prolonged hospital stay, higher mortality, and increased readmission rates among older adults. This study aimed to establish and assess the quality of a multicenter HAD registry database that includes detailed data on nutrition, medication, swallowing, and walking ability. Methods This prospective multicenter study was conducted at nine hospitals in Japan. Patients aged ≥70 years who were independent in ADL (Katz Index = 6) before admission to a general ward for rehabilitation were enrolled. Data were collected at admission and discharge using REDCap. Assessment items included demographics, Katz Index, Functional Comorbidity Index, Clinical Frailty Scale, Global Leadership Initiative on Malnutrition (GLIM) criteria, Food Intake LEVEL Scale (FILS), and Functional Ambulation Categories. HAD was defined as a Katz Index score of less than 6 on discharge. Results A total of 209 patients (median age = 79.0 [75–85] years; 60.8% male) were enrolled. The prevalence of HAD, hospital-associated dysphagia, and weight loss during hospitalization was 29.1%, 16.7%, and 75.4%, respectively. Median length of stay was 19 days (IQR: 13–34), and 82.3% were discharged home. While most variables had low levels of missing data, variables involving body weight demonstrated comparatively higher missingness. Conclusions A multicenter HAD registry database was successfully established, demonstrating the feasibility of prospective data collection across multiple institutions. This registry may facilitate future studies on risk factor identification, predictive model development, and early intervention strategies for HAD prevention.