[Length and outcome of acute inpatient rehabilitation for hospital-associated deconditioning in the elderly].
BACKGROUND
Acute illness and prolonged bed rest might be associated with loss of muscle mass and significant decline in functional ability and mobility, regardless of a specific neurological or orthopedic insult. This condition is commonly termed hospital-associated deconditioning (HAD). To the best of our knowledge to date, acute inpatient rehabilitation length and outcome for HAD in the elderly have never been studied in Israel.


OBJECTIVE
To study which variables are independently associated with the length and mobility outcome of acute inpatient rehabilitation for HAD in the elderly.


METHODS
A retrospective cross-sectional study was conducted during 2009 at the departments of Geriatric Medicine in the Tel-Aviv Medical Center The medical charts of consecutive elderly (< 65 years) patients admitted for rehabilitation due to HAD were studied for the following measurements: demographics, co-morbidities, causes of HAD, admission albumin serum levels, Mini-Mental Status Examination (MMSE) scores, admission transfer and walking Functional Independence Measure (FIM) scores, discharge transfer and walking FIM scores, and rehabilitation length.


RESULTS
The cohort included 103 patients: 57 (55.3%) females and 46 (44.7%) males. The mean age for the entire cohort was 83.6 +/- 6.0 years. The three most common causes of HAD were pneumonia, craniotomy due to intracranial bleeding without neurological insults, and congestive heart failure exacerbation. The mean discharge transfer and walking FIM scores were 5.3 +/- 0.9 and 5.2 +/- 0.8, respectively. The mean length of rehabilitation was 20.4 +/- 13.9 days. Linear regression analysis showed that discharge transfer FIM scores, discharge walking FIM scores, and rehabilitation length were all independently associated with mobility upon admission to rehabilitation (p < 0.0001, p < 0.0001, p = 0.024, respectively). Rehabilitation length was also associated with admission albumin serum levels (p = 0.008).


CONCLUSIONS
The length and mobility outcomes of acute inpatient rehabilitation for HAD in the elderly are associated with mobility upon admission to rehabilitation. Acute inpatient rehabilitation length is also associated with admission albumin serum levels.
Geriatric Division, Tel-Aviv Medical Center, Tet-Aviv, Israel.
Noam
N
Guy
Dan
D
Justo
Yaffa
Y
Lerman
Alexander
A
Rabinovich
D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007297:Inpatients; D007557:Israel; D016014:Linear Models; D008297:Male; D020127:Recovery of Function / Q000502:physiology*; D012046:Rehabilitation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012709:Serum Albumin / Q000378:metabolism; D013997:Time Factors; D016896:Treatment Outcome; D016138:Walking / Q000502:physiology*
D012709:Serum Albumin