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新冠肺炎患者急性住院康复面临的挑战和经验教训:临床表现、评估、需求和服务利用。

Challenges and Lessons Learned for Acute Inpatient Rehabilitation of Persons With COVID-19: Clinical Presentation, Assessment, Needs, and Services Utilization.

机构信息

From the Department of Physical Medicine and Rehabilitation, Donald and Barbara Zucker School of Medicine at Hofstra Northwell, Manhasset, New York (S. Maltser, ABS, OB); Glen Cove Hospital, Glen Cove, New York (S. Maltser, ABS); Burke Rehabilitation Hospital, Albert Einstein College of Medicine, Montefiore Health System, White Plains, New York (ET, MO-P); Rusk Rehabilitation/NYU Grossman School of Medicine, NYU Langone Health (NYU), New York City, New York (HNF, PA); The Feinstein Institutes for Medical Research, Northwell Health, Manhasset, New York (CPS, S. Murphy, OB); Department of Molecular Medicine, Donald and Barbara Zucker School of Medicine at Hofstra Northwell, Hempstead, New York (CPS, OB); Albert Einstein College of Medicine, Montefiore Health System, Bronx, New York (AFA, MNB); Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai (Mount Sinai), New York City, New York (JH, KD-OC, MXE); Rutgers New Jersey Medical School/Kessler Institute for Rehabilitation (Kessler), West Orange, New Jersey (SK, PN, JD); JFK Johnson Rehabilitation Institute at HMH/Rutgers-Robert Wood Johnson Medical School and Hackensack Meridian School of Medicine (JFK Johnson), Edison, New Jersey (LB, SC); Roper Rehabilitation Hospital, Charleston, South Carolina (JD); Department of Neurology, Icahn School of Medicine at Mount Sinai (Mount Sinai), New York City, New York (KD-OC); and NY Presbyterian Columbia Univ. College of Physicians and Surgeons/Weill Cornell School of Medicine (NYP), New York City, New York (SAB).

出版信息

Am J Phys Med Rehabil. 2021 Dec 1;100(12):1115-1123. doi: 10.1097/PHM.0000000000001887.

Abstract

OBJECTIVE

The aim of the study was to present: (1) physiatric care delivery amid the SARS-CoV-2 pandemic, (2) challenges, (3) data from the first cohort of post-COVID-19 inpatient rehabilitation facility patients, and (4) lessons learned by a research consortium of New York and New Jersey rehabilitation institutions.

DESIGN

For this clinical descriptive retrospective study, data were extracted from post-COVID-19 patient records treated at a research consortium of New York and New Jersey rehabilitation inpatient rehabilitation facilities (May 1-June 30, 2020) to characterize admission criteria, physical space, precautions, bed numbers, staffing, employee wellness, leadership, and family communication. For comparison, data from the Uniform Data System and eRehabData databases were analyzed. The research consortium of New York and New Jersey rehabilitation members discussed experiences and lessons learned.

RESULTS

The COVID-19 patients (N = 320) were treated during the study period. Most patients were male, average age of 61.9 yrs, and 40.9% were White. The average acute care length of stay before inpatient rehabilitation facility admission was 24.5 days; mean length of stay at inpatient rehabilitation facilities was 15.2 days. The rehabilitation research consortium of New York and New Jersey rehabilitation institutions reported a greater proportion of COVID-19 patients discharged to home compared with prepandemic data. Some institutions reported higher changes in functional scores during rehabilitation admission, compared with prepandemic data.

CONCLUSIONS

The COVID-19 pandemic acutely affected patient care and overall institutional operations. The research consortium of New York and New Jersey rehabilitation institutions responded dynamically to bed expansions/contractions, staff deployment, and innovations that facilitated safe and effective patient care.

摘要

目的

本研究旨在介绍:(1)SARS-CoV-2 大流行期间的物理治疗服务提供情况,(2)挑战,(3)首批 COVID-19 住院康复设施患者的数据,以及(4)纽约和新泽西州康复机构研究联盟的经验教训。

设计

对于这项临床描述性回顾性研究,从纽约和新泽西州康复住院康复设施的研究联盟(2020 年 5 月 1 日至 6 月 30 日)治疗的 COVID-19 后患者记录中提取数据,以描述入院标准、物理空间、预防措施、床位数量、人员配备、员工健康、领导力和家庭沟通。为了进行比较,还分析了 Uniform Data System 和 eRehabData 数据库中的数据。纽约和新泽西州康复成员的研究联盟讨论了经验和教训。

结果

在研究期间治疗了 320 名 COVID-19 患者。大多数患者为男性,平均年龄为 61.9 岁,40.9%为白人。急性护理入院前平均住院时间为 24.5 天;住院康复设施的平均住院时间为 15.2 天。与大流行前的数据相比,纽约和新泽西州康复机构的研究联盟报告 COVID-19 患者出院回家的比例更高。与大流行前的数据相比,一些机构报告在康复入院期间功能评分的变化更大。

结论

COVID-19 大流行急性影响了患者护理和整体机构运营。纽约和新泽西州康复机构的研究联盟对床位扩展/收缩、人员部署以及促进安全有效的患者护理的创新做出了动态反应。

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