title: The impact of comorbidities and complications on burn injury inpatient rehabilitation outcomes.
abstract: OBJECTIVE
  To examine the impact of comorbidities and complications on burn inpatient rehabilitation facilities (IRF) outcomes.
  
  
  METHODS
  A retrospective cross-sectional study.
  
  
  METHODS
  Inpatient rehabilitation hospitals.
  
  
  METHODS
  A total of 4572 patients with a primary diagnosis of burn injury from the Uniform Data System for Medical Rehabilitation database from 2002 to 2010. METHODS OR INTERVENTIONS: Regression analyses were used to determine whether 3 different comorbidity measures (Charlson Comorbidity Index, Elixhauser Comoribidity Index, Centers for Medicare and Medicaid Services Comorbidity Tiers) and 1 complication measure improved the predictive model (c-statistic) for each outcome measure.
  
  
  METHODS
  Community discharge, Functional Independence Measure (FIM) gain, length of stay efficiency, transfer to acute care within the first 3 days of IRF stay, and transfer to acute care for all time periods.
  
  
  RESULTS
  For all outcomes, there was no difference between the Standard Model and the models that include the comorbidity and complication variables as measured by the c-statistic confidence intervals.
  
  
  CONCLUSIONS
  Comorbidities and complications did not significantly affect burn IRF outcomes. Future research is needed to examine the impact of comorbidities and complications on outcomes of other IRF populations to better understand the implications for current and future health care policy.
authors.affiliation: Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, 125 Nashua St, Boston, MA 02114, USA. jcschneider@partners.org
authors.forename: Jeffrey C
authors.initials: JC
authors.lastname: Schneider
authors.forename: Paul
authors.initials: P
authors.lastname: Gerrard
authors.forename: Richard
authors.initials: R
authors.lastname: Goldstein
authors.forename: Margaret A
authors.initials: MA
authors.lastname: DiVita
authors.forename: Paulette
authors.initials: P
authors.lastname: Niewczyk
authors.forename: Colleen M
authors.initials: CM
authors.lastname: Ryan
authors.forename: Karen
authors.initials: K
authors.lastname: Kowalske
authors.forename: Ross
authors.initials: R
authors.lastname: Zafonte
mesh_terms: D002056:Burns / Q000453:epidemiology / Q000503:physiopathology / Q000534:rehabilitation*; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007297:Inpatients; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D020127:Recovery of Function; D012047:Rehabilitation Centers; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D014481:United States / Q000453:epidemiology; D014946:Wound Infection / Q000453:epidemiology*