Relationship Between Malnutrition and Discharge Disposition from an Inpatient Rehabilitation Facility

2020 ◽  
Vol 120 (9) ◽  
pp. A30
Author(s):  
K. Ives ◽  
R. Clark ◽  
L. Novelo ◽  
S. Cradier
Keyword(s):  
Inpatient Rehabilitation ◽  
Discharge Disposition ◽  
Rehabilitation Facility ◽  
Inpatient Rehabilitation Facility

Abstract 126: Inpatient Rehabilitation Facility Disposition Improves Odds For Good Clinical Outcome After Endovascular Stroke Reperfusion Therapy

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Samir R Belagaje ◽  
Vishal Patel ◽  
Chung-Huan Sun ◽  
Cedric Pimentel ◽  
Brenda Glenn ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Clinical Outcomes ◽  
Binary Logistic Regression ◽  
Inpatient Rehabilitation ◽  
Apache Ii ◽  
Lower Probability ◽  
Good Clinical Outcome ◽  
Discharge Disposition ◽  
Rehabilitation Facility ◽  
Inpatient Rehabilitation Facility

INTRO: A person with stroke has improved outcomes with post-acute care in an inpatient rehabilitation facility (IRF) compared to those who are discharged to a skilled nursing facility (SNF). However, this research was conducted in an era before acute stroke treatment was widely implemented. Endovascular reperfusion reduces ischemic stroke volume; however treatment effect may be diluted by discharge disposition. In this analysis, we hypothesize that patients will have better 90 day outcomes if they are discharged to a IRF or home compared to a SNF. METHODS: Subjects were identified from a prospective database tracking clinical outcomes of patients treated with endovascular reperfusion from a single primary care stroke center. Data included discharge disposition, NIHSS, THRIVE, HIAT-2, & APACHE II scores, and successful reperfusion. Univariate analysis was performed to assess predictors of good clinical outcome as defined by 90 day modified Rankin scores (mRS) ≤ 2. A binary logistic regression model was used to determine the impact placement to IRF versus a SNF on clinical outcomes. RESULTS: 177 subjects were included in the analyis; mean age was 66±14 and median NIHSS was 20. Modified APACHE II, NIHSS, THRIVE, & HIAT-2 scores were not different between the two groups Discharge dispositions included: 35(19.8%)home, 38(21.5%) IRF, 47(26.6%)SNF and 57(32.3%) died/went to hospice. Of the 85 patients discharged to SNF or IRF, only 26% of patients discharged to SNF compared to 50% to IRF achieved a good clinical outcome (p-value <0.03). In binary logistic regression modeling, after adjusting for age, infarct volume, pre-treatment ASPECT & NIHSS scores, and modified APACHE II score, disposition to SNF was significantly associated with a lower probability of achieving a mRS of 0-2 at 90 days, OR 3.31(95%CI 1.06-9.62, p<0.04). CONCLUSIONS: In our study, subjects discharged to SNF and IRF after thrombectomy have similar medical and neurological severity at admission and similar final infarct volumes at discharge. Despite these similarities, patients discharged to SNF had a significantly lower probability of achieving a good neurological outcome. Further study is required to determine if IRF could be considered in more patients to improve clinical outcomes.

Examining the Effectiveness of OT in the Treatment of Patients Recovering From COVID-19 in the Rehabilitation Setting

2021 ◽  
Vol 75 (Supplement_2) ◽  
pp. 7512505157p1-7512505157p1
Author(s):  
Nelle Hannah Ouellette ◽  
Leah Bellinger ◽  
Julie Leonard
Keyword(s):  
Pilot Study ◽  
Daily Living ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Inpatient Rehabilitation ◽  
Assessment Instrument ◽  
Patient Assessment ◽  
Rehabilitation Facility ◽  
Inpatient Rehabilitation Facility ◽  
Primary Author

Abstract Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations. A pilot study was completed to examine the effectiveness of OT in helping individuals regain independence in activities of daily living after COVID-19. In a retrospective chart review, statistically significant results (p &lt; .05) on the Inpatient Rehabilitation Facility Patient Assessment Instrument and the Modified Barthel Index demonstrated that OT is effective in the rehabilitation setting to increase individuals' independence following a COVID-19 diagnosis. Primary Author and Speaker: Nelle Hannah Ouellette Additional Authors and Speakers: Leah Bellinger, Julie Leonard Contributing Authors: Leah Bellinger, Julie Leonard

Physical Function in the Hospital Is Associated With Patient-Centered Outcomes in an Inpatient Rehabilitation Facility

2020 ◽  
Vol 100 (8) ◽  
pp. 1237-1248 ◽  
Author(s):  
Joshua K Johnson ◽  
Julie M Fritz ◽  
Benjamin S Brooke ◽  
Paul C LaStayo ◽  
Anne Thackeray ◽  
...  
Keyword(s):  
Physical Function ◽  
Hospital Discharge ◽  
Short Form ◽  
Academic Medical Center ◽  
Inpatient Rehabilitation ◽  
Acute Hospital ◽  
Adjusted Relative Risk ◽  
Day Hospital ◽  
Rehabilitation Facility ◽  
Inpatient Rehabilitation Facility

Abstract Objective Poor knowledge of the relationships between physical function (PF) in the hospital and patient outcomes in an inpatient rehabilitation facility (IRF) limits the identification of patients most appropriate for discharge to an IRF. This study aimed to test for independent associations between PF measured via the AM-PAC “6-clicks” basic mobility short form in the hospital and outcomes in an IRF. Methods This was a retrospective cohort study. Primary data were collected from an acute hospital and IRF at 1 academic medical center. Associations were tested between PF at hospital admission or discharge and PF improvement in the IRF, discharge from the IRF to the community, and 30-day hospital events by estimating adjusted relative risk (aRR) using modified Poisson regression and the relative difference in IRF length of stay (LOS) using Gamma regression. Results A total of 1323 patients were included. Patients with moderately low, (aRR = 1.50; 95% CI = 1.15–1.93), moderately high (aRR = 1.52; 95% CI = 1.16–2.01), or high (aRR = 1.37; 95% CI = 1.02–1.85) PF at hospital discharge were more likely than those with very low PF to improve their PF while in the IRF. These same patients were more likely to discharge from IRF to the community and had significantly shorter IRF LOS. Hospital-measured PF did not differentiate risk for 30-day hospital events. Conclusion Patients with moderate—but not very low or very high—PF measured near the time of acute hospital discharge were likely to achieve meaningful PF improvement in an IRF. They also had a shorter IRF LOS so may be ideal candidates for discharge to IRF. Prospective studies with larger samples are necessary to test this assertion. Impact Providers in the hospital should identify patients with moderate PF near the time of hospital discharge as those who may benefit most from post-acute rehabilitation in an IRF.

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