Article

The study aimed at assessing the relationship between various Mini
Mental State Examination (MMSE) subdomains and rehabilitation achievements in
post-acute hip-fractured patients. METHOD: Six hundred and five hip-fractured
patients admitted during 2010-2013 to a post-acute geriatric rehabilitation
center were included in the study. Main outcome measures were the Functional
Independence Measure (FIM) instrument, the motor FIM (mFIM), the Montebello
Rehabilitation Factor Score (MRFS) on the mFIM and length of stay (LOS). A
logistic regression analysis tested the predictive value of MMSE subdomains for
achieving a satisfactory functional gain (mFIM MRFS >30%) on operated patients
admitted from community. RESULTS: Of all the six MMSE subdomains, place
orientation and visual construction demonstrated significant predictive values
for rehabilitation outcome. Patients who did not err on place orientation and
visual construction MMSE domains had better probabilities [(OR 1.28, 95%CI,
1.05-1.58; p = 0.017); (OR 2.15, 95%CI, 1.28-3.59; p = 0.004), respectively] of
achieving better rehabilitation achievements. Similar results were obtained for
cognitively impaired patient groups [(OR 1.40 95%CI, 1.11-1.77; p = 0.005); (OR
2.47, 95%CI, 1.15-5.30; p = 0.021), respectively]. For the cognitively intact
patient group, the variables with significant predictive value were time
orientation and visual construction MMSE subdomains [(OR 2.26, 95%CI, 1.18-4.33;
p = 0.014); (OR 2.87, 95%CI, 1.16-7.09; p = 0.022), respectively]. CONCLUSIONS:
Post-acute hip-fractured patients scoring normally on place orientation and
visual construction MMSE subdomains have a better chance of achieving favorable
rehabilitation outcome. Implications for Rehabilitation Post-acute hip-fractured
patients have a better chance to achieve a favorable rehabilitation outcome when
scoring normally on place orientation and visual construction MMSE subdomains.
Patients having difficulties in orientation and visual construction may need more
rehabilitation time as they lack planning and organizational capacity to follow
instructions. Assessing MMSE subdomains may reveal subtle cognitive impairment in
patients scored within the normal range on the MMSE test. Identifying subtle
cognitive impairment may assist in coordinating the patients and their
caregivers' expectations, efficiently allocating resources and help in advanced
care planning.

Langue : ANGLAIS