Article

The purpose of this study was to determine whether prolonged hospital
length of stay (HLOS) and rehabilitation facility length of stay (RLOS) lead to
poor functional outcomes, defined as a Functional Independence Measure (FIM)
score of less than 76 (LFIM) at rehabilitation facility (RF) discharge. DESIGN:
This study analyzed retrospective data collected between 2002 and 2009 on 326
patients in a trauma center and affiliated RF. Factors predicting LFIM at RF
discharge were determined using multivariate logistic regression, chi tests, and
t tests. RESULTS: Significant multivariate predictors of LFIM included age (odds
ratio [OR], 1.05; 95% confidence interval [CI], 1.02-1.07; P < 0.0001), spinal
cord injury (OR, 7.22; 95% CI, 2.73-19.02; P = 0.000), female sex (OR, 2.34; 95%
CI, 1.17-4.65; P = 0.01), and RF admission FIM (OR, 0.93; 95% CI, 0.91-0.95; P <
0.001). An increased risk of LFIM (OR, 2.21; 95% CI, 1.41-3.45; P = 0.001) was
observed with an increased ratio of HLOS/RLOS after adjusting for injury severity
score. CONCLUSION: An increased ratio of HLOS/RLOS increases the risk of LFIM
more than 2-fold after adjusting for injury severity score, spinal cord injury,
and FIM upon RF admission. Delays in transfer to an RF negatively affect patient
functional outcomes. Studies to identify factors affecting delays in transfer
from hospitals to RF should be conducted.

Langue : ANGLAIS