title: Predictors of functional recovery in patients admitted to geriatric postacute rehabilitation.
abstract: OBJECTIVE
  To examine characteristics associated with functional recovery in older patients undergoing postacute rehabilitation.
  
  
  METHODS
  Observational study.
  
  
  METHODS
  Postacute rehabilitation facility.
  
  
  METHODS
  Patients (N=2754) aged ≥65 years admitted over a 4-year period.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Functional status was assessed at admission and again at discharge. Functional recovery was defined as achieving at least 30% improvement on the Barthel Index score from admission compared with the maximum possible room for improvement.
  
  
  RESULTS
  Patients who achieved functional recovery (70.3%) were younger and were more likely to be women, live alone, and be without any formal home care before admission, and they had fewer chronic diseases (all P<.01). They also had better cognitive status and a higher Barthel Index score both at admission (mean ± SD, 63.3±18.0 vs 59.6±24.7) and at discharge (mean ± SD, 86.8±10.4 vs 62.2±22.9) (all P<.001). In multivariate analysis, patients <75 years of age (adjusted odds ratio [OR]=1.51; 95% confidence interval [CI], 1.16-1.98; P=.003), women (adjusted OR=1.24; 95% CI, 1.01-1.52; P=.045), patients living alone (adjusted OR=1.61; 95% CI, 1.31-1.98; P<.001), and patients without in-home help prior to admission (adjusted OR=1.39; 95% CI, 1.15-1.69; P=.001) remained at increased odds of functional recovery. In addition, compared with those with moderate-to-severe cognitive impairment (Mini-Mental State Examination score <18), patients with mild-to-moderate impairment (Mini-Mental State Examination score 19-23) and those cognitively intact also had increased odds of functional recovery (adjusted OR=1.56; 95% CI, 1.13-2.15; P=.007; adjusted OR=2.21; 95% CI, 1.67-2.93; P<.001, respectively).
  
  
  CONCLUSIONS
  Apart from sociodemographic characteristics, cognition is the strongest factor that identifies older patients more likely to improve during postacute rehabilitation. Further study needs to determine how to best adapt rehabilitation processes to better meet the specific needs of this population and optimize their outcome.
authors.affiliation: Service of Geriatric Medicine and Geriatric Rehabilitation, Department of Medicine, Lausanne University Hospital, Lausanne, Switzerland; Institute of Social and Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland. Electronic address: Laurence.Seematter-Bagnoud@chuv.ch.
authors.forename: Laurence
authors.initials: L
authors.lastname: Seematter-Bagnoud
authors.affiliation: Medical Direction, Lausanne University Hospital, Lausanne, Switzerland.
authors.forename: Estelle
authors.initials: E
authors.lastname: Lécureux
authors.affiliation: Service of Geriatric Medicine and Geriatric Rehabilitation, Department of Medicine, Lausanne University Hospital, Lausanne, Switzerland.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Rochat
authors.affiliation: Service of Geriatric Medicine and Geriatric Rehabilitation, Department of Medicine, Lausanne University Hospital, Lausanne, Switzerland.
authors.forename: Stéfanie
authors.initials: S
authors.lastname: Monod
authors.affiliation: Service of Geriatric Medicine and Geriatric Rehabilitation, Department of Medicine, Lausanne University Hospital, Lausanne, Switzerland.
authors.forename: Constanze
authors.initials: C
authors.lastname: Lenoble-Hoskovec
authors.affiliation: Service of Geriatric Medicine and Geriatric Rehabilitation, Department of Medicine, Lausanne University Hospital, Lausanne, Switzerland.
authors.forename: Christophe J
authors.initials: CJ
authors.lastname: Büla
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000072038:Cardiac Rehabilitation; D002561:Cerebrovascular Disorders / Q000534:rehabilitation; D003071:Cognition / Q000502:physiology; D003072:Cognition Disorders / Q000503:physiopathology; D005260:Female; D005767:Gastrointestinal Diseases / Q000534:rehabilitation; D006801:Humans; D057187:Independent Living; D007592:Joint Diseases / Q000534:rehabilitation; D008297:Male; D015999:Multivariate Analysis; D009483:Neuropsychological Tests; D010343:Patient Admission; D020127:Recovery of Function / Q000502:physiology*; D012047:Rehabilitation Centers; D012140:Respiratory Tract Diseases / Q000534:rehabilitation; D012737:Sex Factors; D014947:Wounds and Injuries / Q000534:rehabilitation
keywords: Aged; Health services; MMSE; Mini-Mental State Examination; OR; Recovery of function; Rehabilitation; odds ratio