Article

Heart transplantation (HT) is the treatment of choice for many
patients with end-stage heart failure who remain symptomatic despite optimal
medical therapy, but no study has looked directly into functional improvement of
HT patients after an inpatient rehabilitation program. OBJECTIVE: To determine
functional improvement in HT patients who completed an inpatient rehabilitation
program. DESIGN: Retrospective study. SETTING: An inpatient rehabilitation
facility (IRF) associated with a tertiary care hospital.
PATIENTS: Seventeen
patients admitted between March 2011 and September 2014 after HT. METHODS:
Demographic, clinical, and functional data (admission and discharge Functional
Independence Measure [FIM] scores) were recorded.
Change in FIM scores and FIM
efficiency (change in FIM score/length of stay) were analyzed. FIM outcomes for
HT patients were compared with regional and national averages for patients
undergoing an inpatient rehabilitation program for cardiac debility. As a
secondary outcome, we evaluated whether body mass index of HT patients had an
impact on FIM gains in an IRF. Individual FIM items were analyzed for trends.
Results are reported as mean +/- SD. RESULTS: Twelve male and 5 female patients
with mean age of 61.2 +/- 4.5 years were identified. Three patients were
readmitted to acute hospital because of complications. For those 14 patients who
completed the IRF stay, the mean admission and discharge motor FIM were 51.5
(+/-14.6) and 74.7 (+/-12.0), respectively. The mean admission and discharge
cognition FIM were 30.9 (+/-3.2) and 32.9 (+/-1.7), respectively. The mean total
FIM gain was 26.9 +/- 13.3 (P < .05). The mean FIM efficiency was 3.2 (+/-2.0).
After admission to an IRF, 82% were discharged home with statistically
significant improvement in their functional ability. In addition, all individual
FIM items improved from admission to discharge. There was positive relationship
between body mass index and FIM gain but this was not statistically significant.
CONCLUSIONS: An inpatient rehabilitation program appears to positively impact
optimal outcomes (functional recovery and discharge to home) for selected
patients with HT and is comparable with regional and national FIM gain and
efficiency for patients admitted to IRFs with other cardiac conditions.
CI - Copyright (c) 2016 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS