Impact of pressure ulcers on outcomes in inpatient rehabilitation facilities.

Abstract

OBJECTIVE:

The aim of this study was to examine the impact of pressure ulcers on inpatient rehabilitation facility (IRF) outcomes.

DESIGN:

This is a retrospective analysis of the IRF data in the United States from the Uniform Data System for Medical Rehabilitation between 2009 and 2011. The study sample included 2902 pairs of pressure ulcer and pressure ulcer-free patients upon IRF admission, matching on age at admission, sex, impairment groups, and comorbidity tier measures. The study outcomes were cognition and motor functional gains measured by the Functional Independence Measure instrument, IRF length of stay, and discharge to the community.

RESULTS:

The mean pressure ulcer prevalence upon IRF admission was 5.23%. After controlling for other covariates under study, the pressure ulcer group had a lower motor gain (20.12 vs. 21.58, P < 0.0001), had a longer length of stay (16.5 vs. 15.5, P < 0.0001), and were less likely to be discharged to the community after IRF stay (odds ratio, 0.72; 95% confidence interval, 0.62-0.84) than the patients without a pressure ulcer.

CONCLUSIONS:

The presence of a pressure ulcer among the patients seen in United States IRFs had no impact on cognition functional gain but was associated with a minor lower motor gain, a longer IRF length of stay, and lower odds of being discharged to the community.

• Authors: Hua Wang, Paulette Niewczyk, Maggie Divita, Michelle Camicia, Jed Appelman, Jacqueline Mix, Mary Elizabeth Sandel
• Journal: American journal of physical medicine & rehabilitation (Am J Phys Med Rehabil) Vol. 93 Issue 3 Pg. 207-16 (Mar 2014) ISSN: 1537-7385 [Electronic] United States
• PMID: 24088778 (Publication Type: Comparative Study, Journal Article)

Topics

• Activities of Daily Living
• Amputation, Surgical (rehabilitation)
• Case-Control Studies
• Chi-Square Distribution
• Confidence Intervals
• Congenital Abnormalities (rehabilitation)
• Databases, Factual
• Disability Evaluation
• Female
• Humans
• Inpatients (statistics & numerical data)
• Length of Stay
• Male
• Odds Ratio
• Outcome Assessment, Health Care
• Pressure Ulcer (diagnosis, epidemiology)
• Prevalence
• Recovery of Function
• Rehabilitation Centers
• Retrospective Studies
• Risk Assessment
• Spinal Cord Injuries (rehabilitation)
• Statistics, Nonparametric
• Stroke Rehabilitation
• Treatment Outcome
• United States