Article

OBJECTIVE: To study the functional outcomes of patients with left ventricular
assist devices (LVAD) who were receiving inpatient rehabilitation. DESIGN: This
is a retrospective cohort study of adults with an implanted LVAD admitted to an
acute inpatient rehabilitation unit (IRU) over a 14-month period from March 2010
through May 2011. SETTING: A tertiary care hospital. PATIENTS: This study
included 11 patients with an implanted LVAD who required acute inpatient
rehabilitation. All the patients with LVADs were included irrespective of the
initial admitting diagnosis. Nine patients were admitted for cardiac diagnoses
and underwent LVAD placement before their transfer to the IRU; 2 patients
received LVADs before this hospital admission and were admitted for stroke.
METHODS: Demographic, clinical, and functional data were abstracted. Acute care
length of stay (LOS), IRU LOS, and discharge disposition, along with IRU
Functional Independence Measure (FIM) scores, were analyzed. MAIN OUTCOME
MEASUREMENTS: The primary outcome measurements were IRU LOS, change in functional
status (measured by the FIM), FIM efficiency (FIM gain/LOS), and discharge
setting. RESULTS: The mean +/- standard deviation (SD) IRU LOS was 17.5 +/- 8.9
days. The mean +/- SD FIM gain was statistically significant at 28.6 +/- 10.2 (P
< .0001), and compared favorably to benchmarks for mean FIM gains regionally
(22.5) and nationally (23) for patients admitted to IRUs with a cardiac
diagnosis. The mean (SD) FIM efficiency (FIM gain/IRU LOS) was 1.97 +/- 1.1
compared with the regional mean of 2.27 and national mean of 2.28. Seven of the
11 patients were discharged directly home after inpatient rehabilitation, and 3
returned home after an additional acute hospital stay. One subject died after
transfer back to the acute hospital service. CONCLUSIONS: The patients with LVADs
in this study achieved clinically meaningful functional gains from inpatient
rehabilitation that compared favorably with national benchmarks for patients with
cardiac diagnoses. The majority of the subjects were successfully discharged
home. IRUs should consider implementing rehabilitation programs for this growing
patient population.
CI - Copyright (c) 2013 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS