Predictors of Discharge Destination from an Inpatient Rehabilitation Facility for Patients with Stroke

Talya K. Fleming, MD (Clinical Associate Professor, JFK Johnson Rehabilitation Institute; Rutgers Robert Wood Johnson MS, Hackensack Meridian SOM, Edison, New Jersey); Hayk Petrosyan, PhD; Nicole M. Vendola, .; Helen Xia; Roselyn A. Giordano, BA; Stavros Zinonos, PhD; John Kostis, MD, Phil; Javier Cabrera; William Kostis, PhD, MD; Sara J. Cuccurullo, MD

Meeting: AAPM&R Annual Assembly 2021

Categories: Neurological Rehabilitation (2021)

Session Information

Session Title: AA 2021 Virtual Posters - Neurological Rehabilitation

Session Time: None. Available on demand.

Disclosures: Talya K. Fleming, MD: No financial relationships or conflicts of interest

Objective: To determine factors that predict the discharge destination for patients with stroke in an inpatient rehabilitation facility (IRF).

Design: Retrospective cohort study.Setting : IRF of a suburban, academic medical center.Participants : Adults (N&#3f246) with a diagnosis of ischemic stroke and length of stay (LOS) less than 30 days receiving rehabilitation in an IRF between January 2015 to July 2016.

Interventions: Not applicable.

Main Outcome Measures: Variables included in the analysis were age, gender, race, neuro-intervention, acute care hospital-LOS (ACH-LOS), IRF-LOS, IRF case-mix group (CMG) as a measure of medical complexity, Activity Measure for Post Acute Care (AM-PAC) scores at admission and discharge, and AM-PAC change in scores from admission to discharge. These variables were analyzed for predicting the discharge destination to home, skilled nursing facility (SNF) and acute care hospital (ACH). Positive and negative correlations, multivariable ordinal regression analysis for the discharge destination, and likelihood ratio tests were performed.

Results: Patients had a mean age of 70.5 ± 14.6 (years) with a range of 23-96 and included 137 males and 109 females. The majority of patients were discharged to home 157 (63.8%), with 78 (31.7%) to a SNF and 11 (4.4%) to the ACH. Using univariate analyses, several variables were correlated with discharge destination: neuro-intervention, ACH-LOS, IRF-LOS, CMG, AM-PAC change (daily activity (DA) and basic mobility (BM)), and admission AM-PAC-DA score. Multivariable regression analysis revealed IRF-LOS, CMG, Admission AM-PAC-DA score, AM-PAC-BM change, and AM-PAC-DA change as significant predictive factors of discharge destination with 80% accuracy (p < 0.001). Age, gender, and race were not statistically significant.Conclusions: This study demonstrates that IRF-LOS, CMG, Admission AM-PAC-DA score, AM-PAC-BM change, and AM-PAC-DA change predict discharge destination for stroke survivors from an IRF. Age, gender, and race did not predict discharge destination for stroke survivors. These factors can be used for rehabilitation treatment plans and discharge planning.

Level of Evidence: Level II

To cite this abstract in AMA style:

Fleming TK, Petrosyan H, Vendola NM, Xia H, Giordano RA, Zinonos S, Kostis J, Cabrera J, Kostis W, Cuccurullo SJ. Predictors of Discharge Destination from an Inpatient Rehabilitation Facility for Patients with Stroke [abstract]. PM R. 2021; 13(S1)(suppl 1). https://pmrjabstracts.org/abstract/predictors-of-discharge-destination-from-an-inpatient-rehabilitation-facility-for-patients-with-stroke/. Accessed November 22, 2024.

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