PMID- 25715255
OWN - NLM
STAT- MEDLINE
DCOM- 20150428
LR  - 20231111
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Print)
IS  - 0025-7974 (Linking)
VI  - 94
IP  - 8
DP  - 2015 Feb
TI  - Changes in disability levels among older adults experiencing adverse events in 
      postacute rehabilitation care: a prospective observational study.
PG  - e570
LID - 10.1097/MD.0000000000000570 [doi]
LID - e570
AB  - This study aimed to assess the relationship between adverse events (AEs) and 
      changes in the levels of disability from admission to discharge during inpatient 
      rehabilitation programs. A prospective cohort study was conducted among a cohort 
      of inpatients (216 older adults) admitted to a rehabilitation unit. The 
      occurrences of any AE were reported. The level of disability regarding mobility 
      activities was estimated using the disability qualifiers from the International 
      Classification of Functioning, Disability, and Health. Changes in the levels of 
      disability between admission and discharge were assessed. Baseline-measured 
      covariates were also selected. Regarding all 4 disability levels ("no 
      limitation," "mild," "moderate," "severe," and "complete disability"), a total of 
      159 participants experienced an improvement at discharge (126 participants 
      progressed 1 level, whereas 33 improved 2 disability levels), 56 made no change, 
      and no participants experienced a decline. The occurrence of fall-related events 
      and the diagnostic group (musculoskeletal system) are specific predictive factors 
      of change in the level of disability. The odds of undergoing a change in any 
      disability level between admission and discharge decreases by 68% (1-0.32) when 
      patients experience fall-related events (odds ratio [OR] = 0.32, 95% confidence 
      interval [CI] = 0.11-0.97, P = 0.041) and increases for individuals with 
      musculoskeletal conditions (OR = 3.91, 95% CI = 1.34-11.38, P = 0.012). Our 
      findings suggest that increased efforts to prevent the occurrence of these AEs, 
      together with early interventions suited to the diagnosis of the affected system, 
      may have a positive influence on the improvement of disability. Further studies 
      should evaluate disability over time after discharge to obtain a better sense of 
      how transient or permanent the associated disability may be.
FAU - Gacto-Sanchez, Mariano
AU  - Gacto-Sanchez M
AD  - From the Department of Physical Therapy (MGS), EUSES University School, 
      University of Girona, Girona, Spain; Department of Physical Therapy (FMM, PER), 
      University of Murcia, Murcia, Spain; and Department of Education (ENP), Region of 
      Murcia, Murcia, Spain.
FAU - Medina-Mirapeix, Francesc
AU  - Medina-Mirapeix F
FAU - Navarro-Pujalte, Esther
AU  - Navarro-Pujalte E
FAU - Escolar-Reina, Pilar
AU  - Escolar-Reina P
LA  - eng
PT  - Journal Article
PT  - Observational Study
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
SB  - IM
MH  - Accidental Falls/*statistics & numerical data
MH  - Aged
MH  - Aged, 80 and over
MH  - Disabled Persons/*rehabilitation
MH  - Female
MH  - Humans
MH  - Inpatients/*statistics & numerical data
MH  - Male
MH  - Prospective Studies
MH  - Rehabilitation Centers/*statistics & numerical data
PMC - PMC4554150
COIS- The authors have no funding and conflicts of interest to disclose.
EDAT- 2015/02/26 06:00
MHDA- 2015/04/29 06:00
PMCR- 2015/02/27
CRDT- 2015/02/26 06:00
PHST- 2015/02/26 06:00 [entrez]
PHST- 2015/02/26 06:00 [pubmed]
PHST- 2015/04/29 06:00 [medline]
PHST- 2015/02/27 00:00 [pmc-release]
AID - 00005792-201502040-00007 [pii]
AID - 10.1097/MD.0000000000000570 [doi]
PST - ppublish
SO  - Medicine (Baltimore). 2015 Feb;94(8):e570. doi: 10.1097/MD.0000000000000570.