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European Journal of Physical and Rehabilitation Medicine 2015 Feb 05

Copyright © 2015 EDIZIONI MINERVA MEDICA

lingua: Inglese

Disability and length of stay of hospitalized older adults experiencing adverse events in postacute rehabilitation care: a prospective observational study

Medina-Mirapeix F. 1, Gacto-Sánchez M. 2, Navarro-Pujalte E. 3, Escolar-Reina P. 1

1 Department of Physical Therapy, University of Murcia, Murcia, Spain; 2 Department of Physical Therapy, EUSES University School, University of Girona, Girona, Spain; 3 Education Department, Region of Murcia, Murcia, Spain


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BACKGROUND: Although the literature provides insight into negative consequences among individuals who experience adverse events in acute hospitals, the relationship between adverse events and their consequences in older adults receiving post-­acute rehabilitation care remains unexplored.
AIM: The current study aims to assess the relationship between adverse events and disability at discharge or prolonged stay in inpatient rehabilitation programs.
DESIGN: Prospective cohort study.
SETTING: Rehabilitation unit of a French public hospital.
POPULATION: A cohort of inpatients (216 older adults) admitted to a rehabilitation unit.
METHODS: The occurrences of any adverse event or persisting associated injury were reported. The length of hospital stay during the rehabilitation program was assessed and compared with a standard stay. The level of disability for mobility activities was estimated with the disability qualifiers from the International Classification of Functioning, Disability and Health. Baseline-­measured covariates were also selected.
RESULTS: A total of 26 participants (12.0%) experienced at least 1 adverse event during their hospital stay. Experiencing either fall-­related events or any other kind of adverse event was independently associated with moderate-­severe disability (odds-­ratios: 6.40 and 8.42, respectively) and with prolongation of stay (odds-­ratios: 5.76 and 4.43, respectively) after adjusting for baseline confounders.
CONCLUSION: Older adults who experienced or maintained injuries from adverse events during their rehabilitation stay had more frequently moderate or severe disability in mobility activities and a prolonged hospital stay.
CLINICAL REHABILITATION IMPACT: Data suggest that efforts to prevent the occurrence of these events, as well as early interventions, may have a positive influence on the consequences from adverse events. Further studies should evaluate disability over time, before and after discharge, to obtain a better sense of how transient or permanent the associated disability may be.

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