The Science Journal of the American Association for Respiratory Care

2011 OPEN FORUM Abstracts

INPATIENT REHABILITATION OUTCOMES FOLLOWING LOWER EXTREMITY FRACTURE IN PATIENTS WITH PNEUMONIA.

Ijaz Ahmed1, James E. Graham2, Amol M. Karmarkar2, Carl V. Granger3, Kenneth J. Ottenbacher2; 1Respiratory Care, UTMB, GALVESTON, TX; 2Rehabilitation Science, UTMB, GALVESTON, TX; 3Uniform Data System for Medical Rehabilitation, UDSMR.ORG, Amherst, NY

OBJECTIVE: To assess the impact of pneumonia on inpatient rehabilitation outcomes in persons with lower extremity fracture. METHODS: Secondary data analysis of medical records obtained from 919 facilities that subscribed to the Uniform Data System for Medical Rehabilitation (UDSMR) in 2005-2007. The sample included 153,241 patients who received inpatient rehabilitation services following lower extremity fracture. We used multivariable linear and logistic regressions to evaluate the independent effects of pneumonia on numerical (length of stay and discharge functional status [FIM instrument]) and dichotomous (home discharge [yes / no]) outcomes, respectively. RESULTS: Pneumonia was listed as a comorbity for 4,265 patients (2.8%). Significant (p < 0.01) differences were observed between patients with and without pneumonia in the following variables: age (79.7 +/- 11.0 vs. 77.9 +/- 12.1 years), duration to admission (7.8 +/- 5.0 vs. 5.9 +/- 3.9 days), total number of comorbidities (7.8 +/- 1.8 vs. 7.5 +/- 2.6), admission FIM (56.4 +/- 16.1 vs. 62.2 +/- 15.7), male (38.2% vs. 27.8%), and white race (89.8% vs. 87.5%). The multivariable models indicate that patients with pneumonia on average experienced longer lengths of stay (0.4 days), lower discharge functional status (1.8 FIM points), and lower odds of home discharge (19%) compared to patients with no reimbursement-eligible comorbidity. CONCLUSIONS: This study provides evidence that pneumonia adversely affects inpatient rehabilitation outcomes among persons with lower extremity fracture.
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