Multidisciplinary Inpatient Rehabilitation Following Heart and/or Lung Transplantation-Examining Cohort Characteristics and Clinical Outcomes.

BACKGROUND

Cardiopulmonary transplantation is becoming a more common treatment option for advanced heart and/or lung disease. Specialist rehabilitation programs may assist recovery and enhance functional independence following transplantation.

OBJECTIVE

To quantify the outcomes of multidisciplinary inpatient rehabilitation following cardiopulmonary transplantation and describe cohort characteristics.

DESIGN

Retrospective cohort study.

SETTING

Subacute inpatient rehabilitation facility, located on-site at Australia's largest cardiopulmonary transplant center.

PARTICIPANTS

Heart and/or lung transplant recipients (n = 116), admitted for multidisciplinary inpatient rehabilitation, between 2009 and 2016.

INTERVENTIONS

All participants received multidisciplinary rehabilitation as part of their standard care.

MAIN OUTCOME MEASUREMENTS

Participants' functional independence was scored using the Functional Independence Measure (FIM) upon rehabilitation admission and discharge. Physical measures of mobility and balance were assessed at the same time points, including the 6-minute walk test, 10 m walk, Timed Up and Go, and Berg Balance Scale. Process measures of interest included rehabilitation length of stay, interruptions to rehabilitation, and discharge destination.

RESULTS

Average length-of-stay in rehabilitation was 26.9 ± 21.2 days (mean ± SD). FIM scores improved from 79.8 ± 20.3 on admission to 101.8 ± 29.1 at discharge (P < .001) for the pooled cohort. Physical measures of mobility and balance also improved: 6-minute walk test distances improved from 103.6 ± 80.1 to 183.2 ± 104.8 m (P < .001); Timed Up and Go results decreased from 26.4 ± 18.3 seconds to 16.5 ± 14.1 seconds (P < .001); and Berg Balance Scale scores increased from 26.8 ± 17.1 to 45.0 ± 9.4 (P < .001). Approximately one-third (33.6%) of admissions were interrupted by an acute medical complication; however, this did not preclude completion of rehabilitation or achievement of functional gains. Ninety-four percent of the cohort was discharged to a private residence following rehabilitation. No significant differences were observed between heart versus lung transplant recipients.

CONCLUSIONS

For debilitated patients following heart and/or lung transplantation, physical function, mobility, and independence significantly improved following multidisciplinary inpatient rehabilitation.

LEVEL OF EVIDENCE

III.