Kosasih J B, Borca H H, Wenninger W J, Duthie E
Department of Physical Medicine and Rehabilitation, Medical College of Wisconsin and Veterans Affairs Medical Center, Milwaukee 53295, USA.
Arch Phys Med Rehabil. 1998 Jun;79(6):670-3. doi: 10.1016/s0003-9993(98)90042-9.
To determine the predictive factors and functional outcomes of patients who were discharged from an acute rehabilitation unit to a nursing home care unit (NHCU) at a Veterans Affairs (VA) hospital.
Cohort descriptive study.
An academically affiliated urban VA Medical Center.
All patients (n = 81, median age 68 years) admitted to a VA rehabilitation unit over a 1-year period.
Discharge locations, predictors for NHCU transfer, and functional status as determined by Functional Independence Measure (FIM) scores.
Patients discharged to the NHCU (17%) were compared with those discharged to the community (80%). Multiple logistic regression analysis showed that acute rehabilitation length of stay (LOS), admission, and discharge FIM scores were the only independent variables that predicted discharge to the VA NHCU. Although overall FIM gains in both groups during acute rehabilitation were similar, the NHCU group had significantly lower admission FIM scores and lower LOS efficiency because of longer acute rehabilitation LOS. Postacute NHCU rehabilitation resulted in significant gains in FIM scores at a slower rate. Sixty-four percent of these nursing home patients eventually returned to the community.
Nursing home rehabilitation can result in favorable functional and community outcomes for selected patients.
确定从退伍军人事务部（VA）医院的急性康复单元出院至疗养院护理单元（NHCU）的患者的预测因素和功能转归。
队列描述性研究。
一所与学术机构相关的城市VA医疗中心。
在1年期间入住VA康复单元的所有患者（n = 81，中位年龄68岁）。
出院地点、转至NHCU的预测因素以及通过功能独立性测量（FIM）评分确定的功能状态。
将出院至NHCU的患者（17%）与出院至社区的患者（80%）进行比较。多因素逻辑回归分析显示，急性康复住院时间（LOS）、入院和出院时的FIM评分是预测出院至VA NHCU的仅有的独立变量。尽管两组在急性康复期间FIM的总体改善相似，但NHCU组入院时FIM评分显著更低，且由于急性康复LOS更长，LOS效率更低。急性康复后NHCU康复使FIM评分以较慢速度显著提高。这些疗养院患者中有64%最终回到了社区。
疗养院康复可为特定患者带来良好的功能和社区转归。
