title: Early inpatient rehabilitation admission and stroke patient outcomes.
abstract: OBJECTIVE
  The aim of this study was to examine the associations of onset days, time from stroke onset to inpatient rehabilitation facility (IRF) admission, and patient outcomes (FIM gain, discharge destination, and IRF length of stay), using nationally representative data.
  
  
  METHODS
  A secondary data analysis was conducted on a random sample of stroke patients discharged from IRFs in the United States between 2009 and 2011, including mildly (n = 649), moderately (n = 2185), and severely (n = 2390) impaired patients.
  
  
  RESULTS
  The study sample had a median of onset days of 5.5, with an interquartile range of 4-9. With the use of 15-365 days as reference, the severely impaired patients had a higher cognition gain (P < 0.01) and were more likely to be discharged to the community (odds ratio, 1.45; 95% confidence interval, 1.12-1.87) when admitted within 7 days, a greater motor gain when admitted within 14 days (P < 0.01), and a lower risk for acute hospital transfer when admitted 3-7 days (odds ratio, 0.62; 95% confidence interval, 0.43-0.90). The moderately impaired patients had a greater motor gain when admitted within 7 days (P < 0.01). Early IRF admission was also associated with a shorter length of stay.
  
  
  CONCLUSIONS
  Earlier IRF admission was beneficial among severely and moderately impaired patients. IRF admission within 7 days is recommended for stroke patients who achieved medical stability.
authors.affiliation: From the Kaiser Foundation Rehabilitation Center, Vallejo, California (HW, MC); Uniform Data System for Medical Rehabilitation, Amherst, New York (MD, JM, PN); and State University of New York at Cortland (MD).
authors.forename: Hua
authors.initials: H
authors.lastname: Wang
authors.forename: Michelle
authors.initials: M
authors.lastname: Camicia
authors.forename: Magaret
authors.initials: M
authors.lastname: DiVita
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Mix
authors.forename: Paulette
authors.initials: P
authors.lastname: Niewczyk
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003071:Cognition / Q000502:physiology; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology; D010343:Patient Admission; D020127:Recovery of Function / Q000502:physiology; D012047:Rehabilitation Centers; D020521:Stroke / Q000503:physiopathology / Q000523:psychology; D000071939:Stroke Rehabilitation; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States