Article

OBJECTIVE: To assess the utility of functional status in classifying patients by
discharge setting after inpatient rehabilitation for hip fracture. DESIGN: Retrospective cohort study. SETTING: A total of 1257 inpatient rehabilitation
facilities in the United States. PATIENTS: Medicare beneficiaries (N = 117,168)
receiving inpatient rehabilitation for hip fracture from 2007 to 2009. METHODS:
Receiver operating characteristic curve analyses to assess the overall
discriminatory ability of functional status scores (Functional Independence
Measure [FIM] total, FIM cognition, and FIM motor) and to identify the
functioning threshold that best differentiates patients by discharge setting.
MAIN OUTCOME MEASUREMENTS: Discharge setting (community versus institutional).
RESULTS: Approximately 68% of patients were discharged to the community after
inpatient rehabilitation for hip fracture. Receiver operating characteristic
curve analyses indicate that discharge FIM motor ratings (area under the curve:
0.84) alone are as effective as a multivariable model (area under the curve:
0.85), including sociodemographic and clinical factors, in discriminating
patients discharged to the community from those discharged to an institution. A
discharge FIM motor rating of 58 yielded the best balance in sensitivity and
specificity for classifying patients by discharge setting. CONCLUSIONS: Discharge
FIM motor ratings demonstrated good discriminatory ability for classifying
discharge setting. An FIM motor rating of 58 may serve as a clinical tool to
guide treatment plans and/or as additional information in complex discharge
planning decisions for patients with hip fracture.
CI - Copyright (c) 2014 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS