Sakai Tomoko, Jinno Tetsuya, Hoshino Chisato, Okawa Atsushi
Department of Orthopedics, Tokyo Medical and Dental University, Tokyo, Japan.
Rehabilitation Medicine, Tokyo Medical and Dental University, Tokyo, Japan.
Prog Rehabil Med. 2019 Jun 29;4:20190013. doi: 10.2490/prm.20190013. eCollection 2019.
This study aimed to investigate risk management during acute rehabilitation in cases where rehabilitation was canceled after prescription.
Rehabilitation cases that were judged to be canceled after prescription in our hospital between April 1, 2017, and September 30, 2017, were investigated prospectively. The following parameters were examined: the total number of canceled rehabilitation therapies, the age and sex of the patients, the rehabilitation categories, the reasons for cancellation of rehabilitation, the clinical course after cancellation of rehabilitation, the number of cancellation cases with reasons corresponding to the cancellation criteria from the officially issued guidelines of the Japanese Association of Rehabilitation Medicine, and the applicable elements of the cancellation criteria.
Of the 2263 patients prescribed rehabilitation during the investigation period, rehabilitation was canceled in 110 (4.9%). The reasons for discontinuation were changes in vital signs in 53.6% of these 110 patients. Among the 21 patients in whom rehabilitation was stopped because of decreased oxygen saturation, six were found to have symptomatic pulmonary thromboembolism. In 92.8% of canceled cases, the reasons for cancellation corresponded to the cancellation criteria of rehabilitation. No serious adverse events were noted during the study period.
The judgments of discontinuation of rehabilitation in this study were similar to the cancellation criteria of rehabilitation. Acute rehabilitation should be performed under the control of the cancellation criteria of rehabilitation.
本研究旨在调查在处方开具后康复治疗取消的急性康复期间的风险管理。
对2017年4月1日至2017年9月30日期间在我院被判定为处方开具后取消康复治疗的病例进行前瞻性调查。检查以下参数：取消的康复治疗总数、患者的年龄和性别、康复类别、康复取消的原因、康复取消后的临床病程、符合日本康复医学协会正式发布指南中取消标准的原因的取消病例数，以及取消标准的适用要素。
在调查期间开具康复处方的2263例患者中，110例（4.9%）的康复治疗被取消。在这110例患者中，53.6%的停药原因是生命体征变化。在因血氧饱和度降低而停止康复治疗的21例患者中，6例被发现有症状性肺血栓栓塞。在92.8%的取消病例中，取消原因符合康复治疗的取消标准。在研究期间未观察到严重不良事件。
本研究中康复治疗中止的判断与康复治疗的取消标准相似。急性康复应在康复治疗取消标准的控制下进行。
