Patient Outcomes and Lessons-Learned from Treating Patients with Severe COVID-19 at a Long-Term Acute Care Hospital: A Single-Center Retrospective Analysis (Preprint)

The goal of this study was to describe the characteristics, clinical management, and patient outcomes during, and after, acute COVID-19 phase at Gaylord Specialty Healthcare, a long-term acute care hospital in Wallingford, CT, USA. In this study, we conducted a single-center retrospective analysis of electronic medical records of patients treated for COVID-19-related impairments, from March 19, 2020 through August 14, 2020, to evaluate patient outcomes in response to holistic treatment approach used at our facility. Of the 127 total COVID-19 related patient admissions during this time, 118 were discharged by the data cut-off. Mean patient age was 63 years, 64.1% were male, and 29.9% of patients tested-positive for SARS-CoV-2 infection at admission. The mean (SD) length-of-stay at was 25.5 (13.0) days and there was a positive correlation between patient age and length-of-stay. Of the 51 patients non-ambulatory at admission, 83.3% were ambulatory at discharge. Gait increased 217.4 feet from admission to discharge, a greater increase than the reference cohort of 146.3 feet. 93.8% (15/16) of patients mechanically ventilated at admission were weaned before discharge (mean 11.3 days). 74.7% (56/75) of patients admitted with a restricted diet were discharged on a regular diet. In conclusion, the majority of patients treated at our long-term acute care hospital for severe COVID-19 and related complications improved significantly through coordinated care and rehabilitation.

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Patient Outcomes and Lessons-Learned from Treating Patients with Severe COVID-19 at a Long-Term Acute Care Hospital (Preprint)

10.2196/preprints.31502 ◽

2021 ◽

Author(s):

Peter Grevelding ◽

Henry Charles Hrdlicka ◽

Stephen Holland ◽

Lorraine Cullen ◽

Amanda Meyer ◽

...

Keyword(s):

Length Of Stay ◽

Acute Care ◽

Patient Outcomes ◽

Acute Care Hospital ◽

Lessons Learned ◽

Care Hospital ◽

Patient Age ◽

Holistic Treatment ◽

Patient Âgé

BACKGROUND Patients hospitalized with severe coronavirus disease-2019 (COVID-19) may face long hospital lengths-of-stay, making it unreasonable to expect a discharge to home without long-term consequences.Post-acute care, such as that provided at long-term acute care hospitals (LTACHs) can provide rehabilitation and/or palliative care in the post-COVID phase, as well as provide an alternative to conventional short-term acute care hospitalization (STACH) for active treatment, thereby reducing the burden on the STACH system. OBJECTIVE To describe characteristics, clinical management, and patient outcomes during and after acute COVID-19 phase in a LTACH in the Northeastern United States. METHODS A single-center retrospective analysis of electronic medical records of patients treated for COVID-19-related impairments, from March 19, 2020 through August 14, 2020, was conducted to evaluate patient outcomes in response to the facility’s holistic treatment approach. RESULTS Of the 127 total COVID-19 related patient admissions during this time, 118 admissions were discharged by the data cut-off. Mean patient age was 63 years, 64.1% were male, and 29.9% of patients tested-positive for SARS-CoV-2 infection at admission. The mean (SD) length-of-stay at was 25.5 (13.0) days and there was a positive correlation between patient age and length-of-stay. Of the 51 patients non-ambulatory at admission, 83.3% were ambulatory at discharge. Gait increased 217.4 feet from admission to discharge, a greater increase than the reference cohort of 146.3 feet. 93.8% (15/16) of patients mechanically ventilated at admission were weaned before discharge (mean 11.3 days). 74.7% (56/75) of patients admitted with a restricted diet were discharged on a regular diet. CONCLUSIONS The majority of patients treated at a long-term acute care hospital for severe COVID-19 and related complications improved significantly through coordinated care and rehabilitation.

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