Article

OBJECTIVES: To compare rehabilitation characteristics and patient outcomes
between nonagenarians and younger seniors with hip fracture (HFx), heart failure
(HF), or cerebral vascular accident (CVA). DESIGN: Data only, retrospective
cohort. SETTING: Seven skilled nursing facilities providing rehabilitation
services to a managed care organization. PARTICIPANTS: Subjects (N=2563; age,
>/=65y) with HFx, HF, or CVA receiving rehabilitation services. INTERVENTIONS:
Not applicable. MAIN OUTCOME MEASURES: Patient and rehabilitation characteristics
influencing FIM score at discharge and the proportion of patients discharged to
the community were compared between nonagenarians and younger seniors with HFx,
HF, or CVA. RESULTS: Patients with higher admission FIM scores were discharged
with better function. Different patient characteristics were important for
successful rehabilitation for different conditions and outcomes. Except for HFx,
nonagenarians had admission and discharge characteristics similar to those of
younger seniors, although fewer were discharged to the community. Nonagenarians
and younger seniors with CVA were most similar for all measures. CONCLUSIONS:
Fewer nonagenarians were admitted from the community and fewer were discharged to
the community, even if admitted from the community. Nonagenarians with HFx
differed most strikingly from their younger counterparts in admission and
discharge measures, as well as total discharge FIM score and discharge to the
community. Nonagenarians and younger seniors with CVA were most similar for all
measures. Our results suggest that a large proportion of the nonagenarian
population can benefit from rehabilitation efforts for these 3 conditions;
however, more rehabilitation resources may be required for some conditions to
achieve similar outcomes.
CI - Copyright (c) 2010 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS