From the Department of Physical Medicine and Rehabilitation, University of Texas-Southwestern Medical Center, Dallas, Texas (AM); and Shirley Ryan AbilityLab, Chicago, Illinois (DAG, LR).
Am J Phys Med Rehabil. 2019 Sep;98(9):800-805. doi: 10.1097/PHM.0000000000001200.
The aim of the study was to examine the functional outcomes and medical complications of patients with left ventricular assist device implantation and subsequent stroke during comprehensive inpatient rehabilitation.
Retrospective cohort study of 21 patients admitted to an inpatient rehabilitation facility between 2009 and 2015. Main outcome measurements include admission and discharge Functional Independence Measure, length of stay, and Functional Independence Measure efficiency.
The study included 17 male and 4 female patients aged 32-75 yrs. Eleven patients (52%) required transfer to an acute care hospital for evaluation. Fifteen patients completed inpatient rehabilitation with median [interquartile range] length of stay 26 [13.5-34] days (range = 7-59 days), median [interquartile range] Functional Independence Measure gain of 18 [12.5-32], and median [interquartile range] Functional Independence Measure efficiency of 1.0 [0.6-1.44]. Patients who required transfer to acute care during their course but ultimately completed inpatient rehabilitation (n = 5) demonstrated larger median [interquartile range] Functional Independence Measure gain (40 [23-42]) and longer median [interquartile range] length of stay (35 [35-42]) compared with patients who completed inpatient rehabilitation without transfer (Functional Independence Measure gain = 15 [9.25-26.5]; length of stay = 14.5 [11.5-26.25]).
Patients with left ventricular assist device implantation and subsequent stroke demonstrate functional gains during acute inpatient rehabilitation programs. A large percent of patients required transfer to acute care.
本研究旨在探讨左心室辅助装置植入术后并发卒中患者在综合住院康复期间的功能预后和医疗并发症。
2009 年至 2015 年期间，对入住住院康复机构的 21 例患者进行回顾性队列研究。主要观察指标包括入院和出院时的功能独立性测量（FIM）、住院时间和 FIM 效率。
本研究纳入 17 名男性和 4 名女性患者，年龄 32-75 岁。11 例（52%）患者需要转至急性护理医院进行评估。15 例患者完成住院康复治疗，中位（四分位间距）住院时间 26（13.5-34）天（范围=7-59 天），中位（四分位间距）FIM 增益 18（12.5-32），中位（四分位间距）FIM 效率 1.0（0.6-1.44）。在住院期间需要转至急性护理但最终完成住院康复的 5 例患者（n=5），FIM 增益中位数（四分位间距）更大（40[23-42]），住院时间中位数（四分位间距）更长（35[35-42]），与未转至急性护理而完成住院康复的患者相比（FIM 增益=15[9.25-26.5]；住院时间=14.5[11.5-26.25]）。
左心室辅助装置植入术后并发卒中的患者在急性住院康复计划中表现出功能改善。很大比例的患者需要转至急性护理。
