Key result
Solid organ transplant patients undergoing inpatient rehabilitation had a lower total Functional Independence Measure gain (8.9 vs. 20.9) and longer mean length of stay (27 vs. 20 days) compared to general rehabilitation patients, but achieved a higher rate of discharge to home (98.5% vs. 94.5%).
Why the study?
Does inpatient rehabilitation improve functional outcomes and discharge rates in solid organ transplant recipients compared to general rehabilitation patients?
Observational (n=9,935)
No
Does inpatient rehabilitation improve functional outcomes and discharge rates in solid organ transplant recipients compared to general rehabilitation patients?
Absolute Event Rate: 8.9% vs 20.9%
p-value: p=<0.001
Inpatient rehabilitation for solid organ transplant patients yields acceptable functional improvements and high rates of discharge home, despite higher acute care readmission rates compared to general rehabilitation patients.
May support inpatient rehabilitation for transplant recipients targeting home discharge; leaves open need for prospective trials to optimize functional gains.
Objective: To determine the outcomes in solid organ transplant recipients following inpatient rehabilitation, as a result of a unique partnership between the rehabilitation hospital and the multi-organ transplant program in an acute hospital. Design: Retrospective observational study. Setting: Community rehabilitation hospital affiliated with a university. Participants: A cohort of 173 organ transplant patients admitted consecutively over a four-year period (2004-2008) was compared to a cohort of all rehabilitation patients (n = 9762) admitted to the same inpatient rehab facility during the same period. Interventions: Inpatient rehab program to all participants. Main Outcome Measures: Length of hospital stay, Functional Independence Measure (FIMTM) change (admission-discharge), and rate of discharges to home. Results: Outcomes were measured using components of the FIMTM instrument, admission and discharge data. Chi-square and independent two-sample t-tests were used for statistical analysis. Compared to a general rehabilitation inpatient population, transplant rehabilitation inpatients had: more immediate (TM change (8.9 vs. 20.9, p TM efficiency (1.1 vs. 1.4, p < 0.001); and a higher rate of discharges to home in patients not readmitted to acute care (98.5% vs. 94.5% p < 0.001). Conclusion: Outcomes of rehabilitation in solid organ transplant patients are comparable but not identical to those in other patient groups. Inpatient rehabilitation for transplant patients is therefore fully justifiable and necessary. The ten times higher rate of transplant patient readmission to acute hospital must be communicated, facilitated, accepted and managed within a partnership strategy.
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Patcai et al. (2013) conducted an observational in Solid organ transplantation requiring inpatient rehabilitation (n=9,935). Solid organ transplantation vs. General rehabilitation patients was evaluated on Total Functional Independence Measure (FIM) gain (p=<0.001). Solid organ transplant patients undergoing inpatient rehabilitation had a lower total Functional Independence Measure gain (8.9 vs. 20.9) and longer mean length of stay (27 vs. 20 days) compared to general rehabilitation patients, but achieved a higher rate of discharge to home (98.5% vs. 94.5%).
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