title: Impact of Cognition on Burn Inpatient Rehabilitation Outcomes.
abstract: A significant proportion of burn injury patients are admitted to inpatient rehabilitation facilities (IRFs). There is increasing interest in the use of functional variables, such as cognition, in predicting IRF outcomes. Cognitive impairment is an important cause of disability in the burn injury population, yet its relationship to IRF outcomes has not been studied.
  
  
  
  To assess how cognitive function affects rehabilitation outcomes in the burn injury population.
  
  
  
  Retrospective study.
  
  
  
  Inpatient rehabilitation facilities in the United States.
  
  
  
  A total of 5347 adults admitted to an IRF with burn injury between 2002 and 2011.
  
  
  
  Multivariable regression was used to model rehabilitation outcome measures, using the cognitive domain of the Functional Independence Measure (FIM) instrument as the independent variable and controlling for demographic, medical, and facility covariates.
  
  
  
  FIM total gain, readmission to an acute care setting at any time during inpatient rehabilitation, readmission to an acute care setting in the first 3 days of IRF admission, rate of discharge to the community setting, and length of stay efficiency.
  
  
  
  Cognitive FIM total at admission was a significant predictor of FIM total gain, length of stay efficiency, and acute readmission at 3 days (P < .05). Cognitive FIM total scores did not have an impact on acute care readmission rate or discharge to the community setting.
  
  
  
  Cognitive status may be an important predictor of rehabilitation outcomes in the burn injury population. Future work is needed to further examine the impact of specific cognitive interventions on rehabilitation outcomes in this population.
  
  
  
  II.
authors.affiliation: Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA(∗).
authors.forename: Alexander J
authors.initials: AJ
authors.lastname: Bajorek
authors.affiliation: Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA(†).
authors.forename: Chloe
authors.initials: C
authors.lastname: Slocum
authors.affiliation: Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA(‡).
authors.forename: Richard
authors.initials: R
authors.lastname: Goldstein
authors.affiliation: Uniform Data System for Medical Rehabilitation, Amherst, NY(§).
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Mix
authors.affiliation: Uniform Data System for Medical Rehabilitation, Amherst, NY(‖).
authors.forename: Paulette
authors.initials: P
authors.lastname: Niewczyk
authors.affiliation: Sumner Redstone Burn Center, Surgical Services Massachusetts General Hospital, Harvard Medical School, Boston, MA; Shriners Hospitals for Children-Boston, Boston, MA(¶).
authors.forename: Colleen M
authors.initials: CM
authors.lastname: Ryan
authors.affiliation: Department of Speech-Language Pathology, Spaulding Rehabilitation Hospital, Boston, MA(#).
authors.forename: Carla Tierney
authors.initials: CT
authors.lastname: Hendricks
authors.affiliation: Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA(∗∗).
authors.forename: Ross
authors.initials: R
authors.lastname: Zafonte
authors.affiliation: Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA; Spaulding Rehabilitation Hospital, 300 First Ave, Charlestown, MA 02129(††). Electronic address: jcschneider@partners.org.
authors.forename: Jeffrey C
authors.initials: JC
authors.lastname: Schneider
mesh_terms: D002056:Burns / Q000534:rehabilitation*; D003071:Cognition; D005260:Female; D006801:Humans; D007297:Inpatients; D008297:Male; D008875:Middle Aged; D020127:Recovery of Function; D012047:Rehabilitation Centers; D012189:Retrospective Studies; D016896:Treatment Outcome; D014481:United States