Impact of Cognition on Burn Inpatient Rehabilitation Outcomes.

Impact of Cognition on Burn Inpatient Rehabilitation Outcomes.

PM R. 2016 Jul 9;

Authors: Bajorek AJ, Slocum C, Goldstein R, Mix J, Niewczyk P, Ryan CM, Hendricks CT, Zafonte R, Schneider JC

Abstract
BACKGROUND: A significant proportion of burn injury patients are admitted to inpatient rehabilitation facilities (IRFs). There is increasing interest in the use of functional variables, such as cognition, in predicting IRF outcomes. Cognitive impairment is an important cause of disability in the burn injury population, yet its relationship to IRF outcomes has not been studied.
OBJECTIVE: To assess how cognitive function impacts rehabilitation outcomes in the burn injury population.
DESIGN: Retrospective study; SETTING: U.S. inpatient rehabilitation facilities.
PARTICIPANTS: Subjects included 5,347 adults admitted to an IRF with burn injury between 2002 and 2011.
METHODS: or Interventions: Multivariable regression was used to model rehabilitation outcome measures, using the cognitive domain of the FIM® instrument as the independent variable and controlling for demographic, medical, and facility covariates.
MAIN OUTCOME MEASUREMENTS: FIM® total gain, readmission to an acute care setting at any time during inpatient rehabilitation, readmission to an acute care setting in the first three days of IRF admission, rate of discharge to the community setting, and length of stay efficiency.
RESULTS: Cognitive FIM® total at admission was a significant predictor of FIM® total gain, length of stay efficiency, and acute readmission at three days (p<.05). Cognitive FIM® total scores did not impact acute care readmission rate or discharge to the community setting.
CONCLUSIONS: Cognitive status may be an important predictor of rehabilitation outcomes in the burn injury population. Future work is needed to further examine the impact of specific cognitive interventions on rehabilitation outcomes in this population.

PMID: 27404335 [PubMed - as supplied by publisher]

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