Severe anaemia: implications for functional recovery during rehabilitation.
OBJECTIVE
This case report examines the hospital course and functional recovery of a geriatric patient with severe anaemia undergoing rehabilitation following total hip replacement. It serves to highlight the need for further study of the impact of anaemia on recovery in the rehabilitation setting as well as the importance of developing clinical guidelines for the appropriate medical management of anaemia in this patient population.


METHODS
Single case report.


RESULTS
The course of recovery during rehabilitation in a geriatric patient with severe post-operative anaemia was notably different from other geriatric patients undergoing rehabilitation following total hip replacement. The patient demonstrated a markedly reduced tolerance for therapies and prolonged length of stay, but did not experience cardiopulmonary complications during intensive rehabilitation. Her hematocrit responded nicely to treatment with human recombinant erythropoietin. Despite a prolonged recovery period, the patient ultimately progressed well and achieved a good functional outcome.


CONCLUSIONS
The impact of anaemia on functional recovery in the acute inpatient rehabilitation setting as well as the theoretical risk of increased morbidity and mortality during prescribed therapeutic exercise has not been closely examined in the literature. Further study is indicated to examine the implications for anaemia on functional recovery and cardiopulmonary complications during rehabilitation. General guidelines should be developed for the management of anaemia in the rehabilitation setting.
Diamond
P T
PT
Dept of Physical Medicine and Rehabilitation. University of Virginia Health System, Charlottesville, USA.
D000203:Activities of Daily Living; D000368:Aged; D000740:Anemia / Q000097:blood / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy*; D001172:Arthritis, Rheumatoid / Q000601:surgery; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects* / Q000534:rehabilitation*; D004921:Erythropoietin / Q000627:therapeutic use; D005260:Female; D015577:Geriatric Assessment; D006400:Hematocrit; D006801:Humans; D011182:Postoperative Care / Q000379:methods; D017410:Practice Guidelines as Topic; D020127:Recovery of Function; D012720:Severity of Illness Index
D004921:Erythropoietin