Outcomes of acute inpatient rehabilitation of patients with left ventricular assist devices.
OBJECTIVE
To investigate the benefits of comprehensive inpatient rehabilitation for patients after left ventricular assist device (LVAD) implantation.


METHODS
A retrospective cohort study.


METHODS
An urban academic inpatient rehabilitation hospital.


METHODS
This study included 58 patients admitted to inpatient rehabilitation after LVAD implantation between 2009 and 2012.


METHODS
Chart review of demographic, clinical, and functional data for patients admitted to inpatient rehabilitation after LVAD implantation was performed.


METHODS
Length of stay, admission and discharge Functional Independence Measure (FIM), and FIM efficiency.


RESULTS
The study included 47 male and 11 female patients ages 21.8-84.1 years (mean [standard deviation {SD}], 64.2 ± 11.2 years). The mean (SD) length of time between LVAD implantation and admission to rehabilitation was 27.0 ± 15.3 days. Twenty-one patients (36%) required transfer to an acute care hospital. Ten patients returned after transfer and completed inpatient rehabilitation. For the 47 total patients who completed inpatient rehabilitation, the mean (SD) length of stay was 20.3 ± 10.8 days (range, 7-50 days). Mean (SD) admission and discharge FIM scores were 68.4 ± 13.6 and 91.7 ± 11.8, respectively, with a mean (SD) difference between admission and discharge FIM scores of 23.4 ± 11.2. The mean (SD) FIM efficiency was 1.33 ± 0.65. Complications during rehabilitation included anemia that required transfusion, respiratory distress, epistaxis, gout flare, automated implantable cardioverter defibrillator firing, and gastrointestinal bleeding.


CONCLUSIONS
Patients with LVADs demonstrate functional gains in inpatient rehabilitation. However, there is a high incidence of complications in this population, which often requires transfer to an acute care setting.
Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine and Rehabilitation Institute of Chicago, Chicago, IL∗. Electronic address: samuelkchu@gmail.com.
Samuel K
SK
Chu
Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine and Rehabilitation Institute of Chicago, Chicago, IL†
Zachary
Z
McCormick
Department of Physical Medicine and Rehabilitation, University of Missouri, Columbia, MO‡
Sarah
S
Hwang
Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine and Rehabilitation Institute of Chicago, Chicago, IL§
James A
JA
Sliwa
Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine and Rehabilitation Institute of Chicago, Chicago, IL||
Leslie
L
Rydberg
D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000503:physiopathology / Q000534:rehabilitation*; D006353:Heart-Assist Devices; D006801:Humans; D007297:Inpatients; D007902:Length of Stay / Q000639:trends; D008297:Male; D008875:Middle Aged; D020127:Recovery of Function / Q000502:physiology*; D012047:Rehabilitation Centers; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult