title: Effect of early rehabilitation on activities of daily living in patients with aspiration pneumonia.
abstract: OBJECTIVE
  To assess the effect of early rehabilitation on improving activities of daily living (ADL) in elderly patients with aspiration pneumonia.
  
  
  METHODS
  Using the Japanese Diagnosis Procedure Combination inpatient database, we retrospectively analyzed consecutive patients with aspiration pneumonia at admission who received early rehabilitation (n = 48 201) or did not receive any rehabilitation (n = 64 357) from July 2010 to March 2013. Early rehabilitation was defined as any type of physical rehabilitation initiated within 7 days after admission. The proportions of improved ADL scores from admission to discharge were compared between the early rehabilitation group and the non-rehabilitation group using a multivariable logistic regression analysis and instrumental variable analysis.
  
  
  RESULTS
  The proportion of improved ADL scores was higher in the early rehabilitation group than in the non-rehabilitation group (25.4% vs 33.9%; P < 0.001). The multivariable logistic regression analysis showed that the early rehabilitation group exhibited significant improvement in ADL (odds ratio 1.57; 95% confidence interval 1.50-1.64; P < 0.001). The instrumental variable analysis showed that early rehabilitation was associated with increased proportion of improved ADL (risk difference 8.2%; 95% confidence interval 6.9-9.5%; P < 0.001).
  
  
  CONCLUSIONS
  The present results suggest that early rehabilitation might improve ADL during hospitalization in patients with aspiration pneumonia. Geriatr Gerontol Int 2016; 16: 1181-1187.
authors.affiliation: Department of Rehabilitation, St Marianna University School of Medicine, Toyoko Hospital, Tokyo, Japan.
authors.forename: Maiko
authors.initials: M
authors.lastname: Yagi
authors.affiliation: Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan.
authors.forename: Hideo
authors.initials: H
authors.lastname: Yasunaga
authors.affiliation: Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Matsui
authors.affiliation: Department of Health Policy and Informatics, Tokyo Medical and Dental University Graduate School of Medicine, Tokyo, Japan.
authors.forename: Kiyohide
authors.initials: K
authors.lastname: Fushimi
authors.affiliation: Department of Rehabilitation, National Center for Global Health and Medicine, Tokyo, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Fujimoto
authors.affiliation: Department of Rehabilitation, Tokyo Metropolitan Geriatric Hospital, Tokyo, Japan.
authors.forename: Teruyuki
authors.initials: T
authors.lastname: Koyama
authors.affiliation: Department of Rehabilitation, National Center for Global Health and Medicine, Tokyo, Japan.
authors.forename: Junko
authors.initials: J
authors.lastname: Fujitani
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D016208:Databases, Factual; D061345:Early Medical Intervention / Q000379:methods*; D005260:Female; D015577:Geriatric Assessment; D006760:Hospitalization; D006801:Humans; D007564:Japan; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011015:Pneumonia, Aspiration / Q000175:diagnosis* / Q000534:rehabilitation*; D020127:Recovery of Function; D012046:Rehabilitation / Q000379:methods; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome
keywords: Japanese Diagnosis Procedure Combination inpatient database; activities of daily living; aspiration pneumonia; early rehabilitation; elderly patient