Complications of acute illness and immobilisation
The system-by-system harms of bed rest and acute illness in older inpatients, their time course, the Australian hospital-acquired complications they map to, VTE prophylaxis doses, hypercalcaemia of immobilisation, and a worked day-7 ward review.
Tier 2Medical sciences concept
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- Acute illness plus bed rest harms almost every system in an older person. Creditor (1993) called it the cascade to dependency: immobility causes complications, and the treatments for those complications cause more immobility.
- Muscle and functional loss are covered in deconditioning. This note covers the rest: VTE, pressure injury, pneumonia, delirium, bladder and bowel, orthostatic intolerance, bone and calcium, mood.
- Most of these are on the ACSQHC list of 16 hospital-acquired complications (HACs), which drive funding adjustments for public hospitals.
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Sources
- Hospital-acquired complications (HACs) listAU/NZAustralian Commission on Safety and Quality in Health Care
- Venous Thromboembolism Prevention Clinical Care StandardAU/NZAustralian Commission on Safety and Quality in Health Care, 2020 (under review in 2026)
- Delirium Clinical Care StandardAU/NZAustralian Commission on Safety and Quality in Health Care, 2021
- National Safety and Quality Health Service Standards (Comprehensive Care Standard)AU/NZAustralian Commission on Safety and Quality in Health Care, 2nd edition (2021)
- Comprehensive geriatric assessment for older adults admitted to hospital (Ellis G et al. Cochrane Database Syst Rev 2017;9:CD006211)Cochrane, 2017
- Effectiveness of thigh-length graduated compression stockings to reduce the risk of deep vein thrombosis after stroke (CLOTS trial 1)Lancet 2009;373:1958-65, 2009
- Effectiveness of intermittent pneumatic compression in reduction of risk of deep vein thrombosis in patients who have had a stroke (CLOTS 3)Lancet 2013;382:516-24, 2013
- Hazards of hospitalization of the elderly (Creditor MC. Ann Intern Med 1993;118:219-23)Annals of Internal Medicine, 1993
- Evidence-based recommendations for optimal dietary protein intake in older people: a position paper from the PROT-AGE Study Group (Bauer J et al. J Am Med Dir Assoc 2013;14:542-59)Journal of the American Medical Directors Association, 2013
- Last updated
- 14 November 2026
What changed
- 14 November 2026 Personal emails, About story and Australian-style copy