From the Department of Physical Medicine and Rehabilitation, Mayo Clinic College of Medicine and Science, Rochester, Minnesota (SEJ); and Department of Physical Medicine and Rehabilitation, Mayo Clinic College of Medicine, Mayo Clinic, Rochester, Minnesota (ASDF, RKR).
Am J Phys Med Rehabil. 2020 Jun;99(6):482-486. doi: 10.1097/PHM.0000000000001393.
The aim of the study was to compare outcomes of inpatient rehabilitation after ventricular assist device placement with outcomes for other cardiac diagnoses.
This was a retrospective review of the electronic health records of 265 patients admitted to inpatient rehabilitation: 166 patients were admitted after ventricular assist device placement and 99 were admitted for other cardiac disease. Data collected included functional independence measure score on admission and discharge, dates of admission and discharge, and disposition.
Patients admitted after ventricular assist device placement had a mean functional independence measure gain of 25.7 and length of stay of 8.7 days. Patients admitted for other cardiac diagnoses had a mean functional independence measure gain of 25.9 and length of stay of 9.4 days. These differences were not statistically significant. Change in functional independence measure from admission to discharge was statistically significant within each group (P < 0.001). Most patients were discharged home, and the proportions who returned to acute care or home were not different between groups.
Both the ventricular assist device and nonventricular assist device groups had significant and equivalent improvements in functional outcomes after inpatient rehabilitation. This study found that ventricular assist device patients benefit from inpatient rehabilitation with similar disposition rates as patients with other cardiac diagnoses. Inpatient rehabilitation is the appropriate setting for this group.
Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME CME OBJECTIVES: Upon completion of this article, the reader should be able to: (1) Describe the role of rehabilitation in the care of individuals after ventricular assist device (VAD) placement; (2) Compare the outcomes of inpatient rehabilitation for individuals after VAD placement to those admitted for other cardiac reasons; and (3) Recognize potential complications that may occur during the course of a VAD patient's inpatient rehabilitation stay.
Advanced ACCREDITATION: The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.The Association of Academic Physiatrists designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
本研究旨在比较心室辅助装置(VAD)植入后住院康复治疗的结果与其他心脏诊断的结果。
这是对 265 名住院康复患者的电子健康记录进行的回顾性分析:166 名患者因 VAD 植入后住院,99 名患者因其他心脏疾病住院。收集的数据包括入院和出院时的功能独立性测量(FIM)评分、入院和出院日期以及去向。
VAD 植入后住院的患者 FIM 平均增益为 25.7,住院时间为 8.7 天。因其他心脏诊断住院的患者 FIM 平均增益为 25.9,住院时间为 9.4 天。这些差异无统计学意义。每组内 FIM 从入院到出院的变化均有统计学意义(P<0.001)。大多数患者出院回家,两组之间返回急性护理或回家的比例无差异。
VAD 和非 VAD 组在住院康复后功能结局均有显著且相当的改善。本研究发现,VAD 患者从住院康复中获益,其出院去向与其他心脏诊断患者相似。住院康复是该类患者的合适场所。
CME 学分申请:在 http://www.physiatry.org/JournalCME 上完成自我评估活动和在线评估
CME 目标:完成本文后,读者应能够:(1)描述康复在 VAD 后个体护理中的作用;(2)比较 VAD 后患者住院康复治疗的结果与因其他心脏原因住院的结果;(3)认识到 VAD 患者住院康复期间可能出现的潜在并发症。
级别:高级
认证:学术物理治疗医师协会(AAP)经继续医学教育认证委员会(ACCME)认证,可为医师提供继续医学教育。学术物理治疗医师协会将此次基于期刊的 CME 活动最多指定为 1.0 项 AMA PRA 类别 1 学分。医师应仅根据其参与活动的程度申报学分。