Session Time: 12:30pm-2:00pm
Location: Research Hub - Kiosk 1
Disclosures: Mazen Zein, DO: Nothing to disclose
Case Description: Bi-ventricular assistive devices (BiVADs) serve as both a bridge to heart transplant or destination therapy for individuals who are not candidates for transplant. The patient was followed and evaluated by a team of physicians, therapists and nursing staff for functional outcome and adverse events related to their IPR stay. Functional Independence Measure (FIM) instrument scores were gathered upon admission and at discharge from IPR. The main independent variables included activities of daily living, transfers, ambulation/wheelchair, and stairs.
Setting: Inpatient acute care rehabilitation center
Patient: A 60-year-old African American male status-post BiVAD placement.
Assessment/Results: Comparison of admission to discharge FIM scores demonstrated improvement in mobility from total assistance to supervision. Ambulation progressed from none to 50 feet with rolling walker and supervision, and wheelchair mobility increased from total assistance to 150 ft with supervision. Both ADLs and transfers improved from maximum assistance to complete independence. His rehabilitation was complicated by several adverse events. On one occasion, the patient developed symptoms of fluid overload and had an acute drop in hemoglobin necessitating an acute care transfer. During his second IPR stay he developed a prolonged episode of epistaxis secondary to supratherapeutic INR that required treatment by ENT. He also experienced an episode of symptomatic tachycardia requiring pacemaker interrogation. Patient was able to be stabilized and continue IPR after each individual event.
Discussion: To date, there are no reports on post-operative BiVAD patient functional outcome and adverse events after admission to inpatient rehabilitation (IPR).
Conclusion: Our patient demonstrated significant functional improvement in multiple FIM scores. BiVAD patients will become more prevalent in acute IPR as these medical devices continue to be a therapeutic option for combination right and left sided heart failure. Physiatrists must have an understanding of BiVAD patient outcomes and possible adverse events (i.e. Bleeding, arrhythmias, respiratory failure, etc.).
Level of Evidence: Level V
To cite this abstract in AMA style:Zein M. Functional Outcome Measures and Adverse Events Related to a Patient Admitted to Inpatient Rehabilitation Status-post Bi-ventricular Assist Device (BiVAD) Placement: A Case Report [abstract]. PM R. 2019; 11(S2)(suppl 2). https://pmrjabstracts.org/abstract/functional-outcome-measures-and-adverse-events-related-to-a-patient-admitted-to-inpatient-rehabilitation-status-post-bi-ventricular-assist-device-bivad-placement-a-case-report/. Accessed October 23, 2021.
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