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Risk factors for discharge to an acute care hospital from inpatient rehabilitation among stroke patients.
Roberts, Pamela S; DiVita, Margaret A; Riggs, Richard V; Niewczyk, Paulette; Bergquist, Brittany; Granger, Carl V.
Afiliación
  • Roberts PS; Department of Rehabilitation, Cedars-Sinai Medical Center, 8631 West Third St, Suite 915 East, Los Angeles, CA 90048(∗). Electronic address: pamela.roberts@cshs.org.
  • DiVita MA; Uniform Data System for Medical Rehabilitation, Amherst; and Department of Social and Preventive Medicine, State University of New York at Buffalo, Buffalo, NY(†).
  • Riggs RV; Department of Rehabilitation, Cedars-Sinai Medical Center, Los Angeles, CA(‡).
  • Niewczyk P; Uniform Data System for Medical Rehabilitation; and Daemen College, Health Care Studies Department, Amherst, NY(§).
  • Bergquist B; Department of Rehabilitation, Cedars-Sinai Medical Center, Los Angeles, CA(‖).
  • Granger CV; Uniform Data System for Medical Rehabilitation, Amherst, NY(¶).
PM R ; 6(1): 50-5; quiz 55, 2014 Jan.
Article en En | MEDLINE | ID: mdl-23973503
OBJECTIVE: To identify medical and functional health risk factors for being discharged directly to an acute-care hospital from an inpatient rehabilitation facility among patients who have had a stroke. DESIGN: Retrospective cohort study. SETTING: Academic medical center. PARTICIPANTS: A total of 783 patients with a primary diagnosis of stroke seen from 2008 to 2012; 60 were discharged directly to an acute-care hospital and 723 were discharged to other settings, including community and other institutional settings. METHODS OR INTERVENTIONS: Logistic regression analysis. MAIN OUTCOME MEASUREMENTS: Direct discharge to an acute care hospital compared with other discharge settings from the inpatient rehabilitation unit. RESULTS: No significant differences in demographic characteristics were found between the 2 groups. The adjusted logistic regression model revealed 2 significant risk factors for being discharged to an acute care hospital: admission motor Functional Independence Measure total score (odds ratio 0.97, 95% confidence interval 0.95-0.99) and enteral feeding at admission (odds ratio 2.87, 95% confidence interval 1.34-6.13). The presence of a Centers for Medicare and Medicaid-tiered comorbidity trended toward significance. CONCLUSION: Based on this research, we identified specific medical and functional health risk factors in the stroke population that affect the rate of discharge to an acute-care hospital. With active medical and functional management, early identification of these critical components may lead to the prevention of stroke patients from being discharged to an acute-care hospital from the inpatient rehabilitation setting.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Alta del Paciente / Rehabilitación de Accidente Cerebrovascular Tipo de estudio: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Aged80 / Female / Humans / Male / Middle aged País/Región como asunto: America do norte Idioma: En Revista: PM R Asunto de la revista: MEDICINA FISICA / REABILITACAO / TRAUMATOLOGIA Año: 2014 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Alta del Paciente / Rehabilitación de Accidente Cerebrovascular Tipo de estudio: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Aged80 / Female / Humans / Male / Middle aged País/Región como asunto: America do norte Idioma: En Revista: PM R Asunto de la revista: MEDICINA FISICA / REABILITACAO / TRAUMATOLOGIA Año: 2014 Tipo del documento: Article Pais de publicación: Estados Unidos