From the Department of Internal Medicine, Division of Cardiovascular Diseases (OA, SSK, ALC, RJT, FL-J, CMP-T), Department of Physical Medicine and Rehabilitation (RKR, MDP, TLT, DJE, MLV, SMK, CMP-T), and Department of Cardiac Surgery (SJP), Mayo Clinic, Rochester, Minnesota.
Am J Phys Med Rehabil. 2014 Oct;93(10):860-8. doi: 10.1097/PHM.0000000000000101.
The aim of this study was to evaluate outcomes of patients participating in inpatient rehabilitation program after left ventricular assist device (LVAD) implantation.
Medical records of 94 patients who received LVADs between January 1, 2008, and June 30, 2010, at the Mayo Clinic in Rochester, MN, were retrospectively reviewed for demographic data, and inpatient rehabilitation functional outcomes were measured by the Functional Independence Measure scale.
After successful implantation of LVAD, the patients were either discharged directly home from acute care (44%) or admitted to inpatient rehabilitation (56%). The patients admitted to inpatient rehabilitation were older than those discharged home. They were also more medically complex and more likely to have the LVAD placed as destination therapy. At discharge, significant improvement occurred in 17 of the 18 activities evaluated by the Functional Independence Measure scale. The mean total Functional Independence Measure scale score at admission was 77.1 compared with a score of 95.2 at discharge (P < 0.0001).
Approximately half of the patients who received LVAD therapy were admitted in the inpatient rehabilitation. After the implantation of LVAD and inpatient rehabilitation, significant functional improvements were observed. Further studies addressing the role of inpatient rehabilitation for LVAD patients are warranted.
本研究旨在评估左心室辅助装置(LVAD)植入术后参与住院康复计划患者的结局。
回顾性分析 2008 年 1 月 1 日至 2010 年 6 月 30 日期间在明尼苏达州罗切斯特市梅奥诊所接受 LVAD 的 94 例患者的病历资料,以获取人口统计学数据,并使用功能独立性测量量表(FIM)衡量住院康复的功能结局。
LVAD 成功植入后,患者要么直接从急性护理出院(44%),要么入院接受住院康复(56%)。入院接受住院康复的患者比直接出院的患者年龄更大。他们的医疗状况也更复杂,更有可能将 LVAD 作为终末期治疗。出院时,FIM 量表评估的 18 项活动中有 17 项显著改善。入院时的平均总 FIM 量表评分为 77.1,出院时评分为 95.2(P<0.0001)。
约一半接受 LVAD 治疗的患者入院接受住院康复。植入 LVAD 并接受住院康复后,观察到显著的功能改善。需要进一步研究住院康复在 LVAD 患者中的作用。