title: Risk factors for discharge to an acute care hospital from inpatient rehabilitation among stroke patients.
abstract: OBJECTIVE
  To identify medical and functional health risk factors for being discharged directly to an acute-care hospital from an inpatient rehabilitation facility among patients who have had a stroke.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  Academic medical center.
  
  
  METHODS
  A total of 783 patients with a primary diagnosis of stroke seen from 2008 to 2012; 60 were discharged directly to an acute-care hospital and 723 were discharged to other settings, including community and other institutional settings.
  
  
  METHODS
  Logistic regression analysis.
  
  
  METHODS
  Direct discharge to an acute care hospital compared with other discharge settings from the inpatient rehabilitation unit.
  
  
  RESULTS
  No significant differences in demographic characteristics were found between the 2 groups. The adjusted logistic regression model revealed 2 significant risk factors for being discharged to an acute care hospital: admission motor Functional Independence Measure total score (odds ratio 0.97, 95% confidence interval 0.95-0.99) and enteral feeding at admission (odds ratio 2.87, 95% confidence interval 1.34-6.13). The presence of a Centers for Medicare and Medicaid-tiered comorbidity trended toward significance.
  
  
  CONCLUSIONS
  Based on this research, we identified specific medical and functional health risk factors in the stroke population that affect the rate of discharge to an acute-care hospital. With active medical and functional management, early identification of these critical components may lead to the prevention of stroke patients from being discharged to an acute-care hospital from the inpatient rehabilitation setting.
authors: Department of Rehabilitation, Cedars-Sinai Medical Center, 8631 West Third St, Suite 915 East, Los Angeles, CA 90048(∗). Electronic address: pamela.roberts@cshs.org.
authors: Pamela S
authors: PS
authors: Roberts
authors: Uniform Data System for Medical Rehabilitation, Amherst; and Department of Social and Preventive Medicine, State University of New York at Buffalo, Buffalo, NY(†).
authors: Margaret A
authors: MA
authors: DiVita
authors: Department of Rehabilitation, Cedars-Sinai Medical Center, Los Angeles, CA(‡).
authors: Richard V
authors: RV
authors: Riggs
authors: Uniform Data System for Medical Rehabilitation; and Daemen College, Health Care Studies Department, Amherst, NY(§).
authors: Paulette
authors: P
authors: Niewczyk
authors: Department of Rehabilitation, Cedars-Sinai Medical Center, Los Angeles, CA(‖).
authors: Brittany
authors: B
authors: Bergquist
authors: Uniform Data System for Medical Rehabilitation, Amherst, NY(¶).
authors: Carl V
authors: CV
authors: Granger
mesh_terms: D000046:Academic Medical Centers; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D015897:Comorbidity; D004185:Disability Evaluation; D004750:Enteral Nutrition / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D016015:Logistic Models; D015141:Los Angeles; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge; D012047:Rehabilitation Centers; D012189:Retrospective Studies; D012307:Risk Factors; D000071939:Stroke Rehabilitation