Article

OBJECTIVE: To determine the patient-, treatment-, and facility-level factors that
are associated with home discharge among male veterans with lower extremity
amputation who received inpatient rehabilitation after surgery. DESIGN: A
retrospective observational study. SETTING:
Veterans Affairs Medical Centers.
This study included 1480 male veterans. METHODS: Generalized
estimating equation models were used to model the likelihood of home discharge to
account for within-facility clustering. We reported odds ratios (ORs) and 95%
confidence intervals (95% CIs). MAIN OUTCOME MEASUREMENT: Discharged to home.
RESULTS: There were a total of 1163 (78.6%) veterans who were discharged home
after the surgical hospitalization, compared with other locations. Patients who
were married were more likely to be discharged home compared with patients who
were not married (OR = 1.51, 95% CI = 1.14-1.99, P < .01). Compared with being
transferred from another hospital or extended care, patients who were admitted
from home were far more likely to be discharged home (OR = 8.43, 95% CI =
5.48-12.96, P < .0001). Patients with evidence of local significant infection
were less likely to be discharged home (OR = 0.57, 95% CI = 0.39-0.83, P < .01),
as were patients with evidence of congestive heart failure (OR = 0.62, 95% CI =
0.45-0.85, P < .01) or depression (OR = 0.63, 95% CI = 0.40-0.98, P = .04).
Veterans with greater discharge motor Functional Independence Measure scores were
more likely to be discharged home (OR = 1.23, 95% CI = 1.16-1.31 per 10-point
increase in discharge Functional Independence Measure motor score, P < .0001).
Conversely, patients undergoing procedures for ongoing active cardiac pathology
were less likely to be discharged home (OR = 0.55, 95% CI = 0.37-0.81, P < .01).
CONCLUSIONS: This study showed a strong association between the sociological
factors of marital status and living location before hospitalization and home
discharge. The significance of discharge functional status highlights the
importance of addressing the expected care burden once patients are discharged home.
CI - Copyright (c) 2013 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS