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Inpatient rehabilitation outcome: a matter of diagnosis?

DOI: http://dx.doi.org/10.2147/NDT.S39922

Keywords: diagnosis, rehabilitation, inpatients, outcome

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patient rehabilitation outcome: a matter of diagnosis? Original Research (480) Total Article Views Authors: Bejor M, Ramella FC, Dalla Toffola E, Comelli M, Chiappedi M Published Date February 2013 Volume 2013:9 Pages 253 - 257 DOI: http://dx.doi.org/10.2147/NDT.S39922 Received: 04 November 2012 Accepted: 30 November 2012 Published: 18 February 2013 Maurizio Bejor,1 Francesca Chiara Ramella,1 Elena Dalla Toffola,1 Mario Comelli,2 Matteo Chiappedi3 1University of Pavia, Department of Surgical, Resuscitative, Rehabilitative and Transplant Sciences, Pavia, Italy; 2University of Pavia, Department of Brain Sciences, Medical Statistics Section, Pavia, Italy; 3Don Carlo Gnocchi ONLUS Foundation, Milan, Italy Background: Patients with comorbidities are becoming more and more common in Italian rehabilitative wards. These comorbidities are considered a major problem for inpatient rehabilitation, due to the fact that they cause longer lengths of stay, higher costs, and lower functional results. Methods: To investigate the possible relationships between comorbidity, functional impairment, age, and type of discharge in patients hospitalized in postacute rehabilitation facilities, we planned an observational study. A total of 178 consecutive inpatients (average age: 78 years [range: 39–99]) from postacute rehabilitation facilities were recruited. Primary diagnosis, comorbidity rating (Cumulative Illness Rating Scale – Geriatric version, CIRS-G) and functional impairment score (Functional Independence Measure, FIM ) were evaluated at admission. The FIM rating was also assessed at hospital discharge. Results: A total of 178 of the 199 enrolled patients completed the rehabilitation treatment (89.4%). The average length of stay was 46 ± 24 days. CIRS-G showed an average comorbidity score for each patient of 4.45 ± 1.69. The average FIM rating was 79 ± 24.88 at admission, and 91.9 ± 25.7 at discharge. Diagnosis at admission (grouped according to the International Classification of Diseases 9-CM) seemed to correlate with functional results, since lower rehabilitative efficiency was obtained for patients who had a history of stroke. Conclusion: The number and type of comorbidities (CIRS-G) in rehabilitation inpatients do not seem to affect functional outcomes of treatment. The determining factor for a lower level of functional recovery seems to be the diagnosis at admission.

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