DiVita Margaret A, Mix Jacqueline M, Goldstein Richard, Gerrard Paul, Niewczyk Paulette, Ryan Colleen M, Kowalske Karen, Zafonte Ross, Schneider Jeffrey C
Uniform Data System for Medical Rehabilitation, 270 Northpointe Parkway, Amherst, NY 14228; and Health Department, State University of New York at Cortland, Cortland, NY∗.
Uniform Data System for Medical Rehabilitation, Amherst, NY(†).
PM R. 2014 Nov;6(11):999-1007. doi: 10.1016/j.pmrj.2014.05.010. Epub 2014 May 28.
Burn survivors tend to have complex medical issues requiring rehabilitation to improve overall function and quality of life. A subset of burn patients treated in inpatient rehabilitation facilities (IRFs) may require more than 1 rehabilitation stay for the same injury.
To compare the rehabilitation outcomes among burn patients admitted to an IRF who were discharged to acute care and then readmitted to an IRF with burn patients admitted to an IRF only 1 time.
Retrospective cohort study.
Inpatient rehabilitation facilities.
Burn injury patients aged 18 years or more who were admitted to IRFs between 2002 and 2011.
We performed a secondary analysis of data from Uniform Data System for Medical Rehabilitation, a national data repository. Outcomes of the repeaters' second stay (n = 188) were compared to the nonrepeaters' first and only stay (n = 6,855), using linear regression and logistic regression to determine whether repeater status was associated with rehabilitation outcomes.
Functional status (using the Functional Independence Measure [FIM] instrument) at admission, discharge and change, length of stay, FIM efficiency (total FIM points gained per day), and discharge disposition.
Repeater status was inversely associated with discharge FIM total (coefficient = -3.42, 95% confidence interval = -5.76, -1.07) and FIM change (coefficient = -4.05, 95% CI = -6.34, -1.75) in linear regression models. No other significant differences were found, and those differences in discharge FIM total and FIM change were small.
Differences found in rehabilitation outcomes between the repeater and nonrepeater groups were small and may not reflect clinically meaningful differences. Burn injury patients who required a second IRF admission had rehabilitation outcomes similar to those of burn injury patients who did not require a second IRF admission, emphasizing the value of inpatient rehabilitation for burn injury IRF readmissions.
烧伤幸存者往往存在复杂的医疗问题，需要进行康复治疗以改善整体功能和生活质量。在住院康复机构（IRF）接受治疗的一部分烧伤患者可能因同一损伤需要不止一次康复住院。
比较入住IRF后出院至急性护理机构，然后再次入住IRF的烧伤患者与仅入住IRF一次的烧伤患者的康复结局。
回顾性队列研究。
住院康复机构。
2002年至2011年间入住IRF的18岁及以上烧伤患者。
我们对来自全国数据存储库医学康复统一数据系统的数据进行了二次分析。使用线性回归和逻辑回归比较再次住院者第二次住院（n = 188）与非再次住院者第一次也是唯一一次住院（n = 6855）的结局，以确定再次住院状态是否与康复结局相关。
入院时、出院时及变化时的功能状态（使用功能独立性测量[FIM]工具）、住院时间、FIM效率（每天获得的FIM总分）及出院处置情况。
在线性回归模型中，再次住院状态与出院时FIM总分（系数 = -3.42，95%置信区间 = -5.76，-1.07）和FIM变化（系数 = -4.05，95%CI = -6.34，-1.75）呈负相关。未发现其他显著差异，且出院时FIM总分和FIM变化的差异较小。
再次住院者和非再次住院者组在康复结局上的差异较小，可能未反映出临床上有意义的差异。需要第二次入住IRF的烧伤患者的康复结局与不需要第二次入住IRF的烧伤患者相似，这强调了住院康复对烧伤患者再次入住IRF的价值。
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