Abstract Details

Title Unplanned Interruption of Acute Rehabilitation after Stroke

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P16 - Poster Session 16 (5:30 PM-6:30 PM)

Poster/Presentation
Number 4-005

Objective To identify causes for the unplanned transfer of patients with a stroke from inpatient rehabilitation facility (IRF) to acute care hospital.

Background A better understanding of the causes will allow us to predict and minimize such incidents.

Design/Methods Data was exported using Uniform Data System for Medical Rehabilitation. We identified patients with a stroke diagnosis who discharged from IRF to acute care hospital 2005-2018 (transfer cohort). We excluded patients who were readmitted for planned procedures. This cohort was compared to an age/sex-matched control group of patients with a stroke who were admitted to IRF within the same timeframe and successfully completed their rehabilitation stay (control cohort). We compared the two groups using appropriate statistical tests (equal variance unpaired t-test, Wilcoxon, chi-square test). All analysis was performed in SAS 9.4 and significance was determined using a two-sided alpha of 0.05.

Results

There were 92 patients in the transfer cohort (age 65±13 years; 38% female; 74% white; 74% ischemic). Control cohort (75% white; 76% ischemic) had similar NIHSS as transfer cohort. For the transfer cohort, median length of stay at IRF was 9 (IQR 4-13) days. Most common indications for transfer were neurological (31%) and cardiovascular (28%). Compared to control, the transfer cohort had statistically higher rates of comorbid medical conditions (A fib, heart, renal, respiratory disease, and metabolic diseases), lower mean Functional Independence Measure (FIM) score on admission (52±19 vs 64±18; p=0.001), and higher rate of prescribed sedatives/hypnotics (82% vs. 23%; p<0.001) during their IRF stay. Only 43% of the transfer cohort returned to IRF, 18% died and the rest discharged elsewhere.

Conclusions The most common causes for transfer from IRF to an acute care hospital were neurological and cardiopulmonary. Transfer patients have high medical complexity, low FIM, and were subjected to sedatives/hypnotics, therefore practitioners should be vigilant in patients who meet these criteria.

Authors/Disclosures
Amanda A. Herrmann, PhD (HealthPartners Neuroscience Center) PRESENTER	No disclosure on file
	No disclosure on file
	No disclosure on file
Sally I. Othman	No disclosure on file
	No disclosure on file
	No disclosure on file
Haitham Hussein, MD, F�鶹��ýӳ�� (University of Minnesota Medical School)	Dr. Hussein has nothing to disclose.

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