Article

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. OBJECTIVE:
To assess how cognitive function affects rehabilitation outcomes in the burn
injury population. DESIGN: Retrospective study. SETTING: Inpatient rehabilitation
facilities in the United States. PARTICIPANTS: A total of 5347 adults admitted to
an IRF with burn injury between 2002 and 2011. METHODS OR INTERVENTIONS:
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. MAIN OUTCOME MEASUREMENTS: 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. RESULTS: 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. CONCLUSIONS: 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. LEVEL OF EVIDENCE: II.
CI - Copyright (c) 2017 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.
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Langue : ANGLAIS