Length of Stay at Inpatient Rehabilitation Facility and Stroke Patient Outcomes

Wrong way to think about this. If you really want to know how to predict patient outcomes you have to have objective diagnosis of dead areas and the penumbra.
Medium f*cking whoopee.

http://onlinelibrary.wiley.com/doi/10.1002/rnj.218/abstract;jsessionid=95AA7FF424609AD0515CE84EFCD7D517.f02t04?

1. Michelle Camicia MSN, CRRN, CCM^1,*,
2. Hua Wang PhD¹,
3. Margaret DiVita PhD, MS²,
4. Jacqueline Mix MPH³ and
5. Paulette Niewczyk PhD, MPH³

Article first published online: 22 MAY 2015

DOI: 10.1002/rnj.218

© 2015 Association of Rehabilitation Nurses

Issue

Rehabilitation Nursing

Early View (Online Version of Record published before inclusion in an issue)

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Keywords:

• Stroke;
• rehabilitation;
• length of stay;
• outcomes

Abstract

Purpose

To examine the association of inpatient rehabilitation facility (IRF) length of stay (LOS) with stroke patient outcomes.

Design

A secondary data analysis of the Uniform Data System for Medical Rehabilitation database.

Methods

Stroke patients discharged from IRFs in the United States between 2009 and 2011 were identified and divided into mild (n = 639), moderate (n = 2,065), and severely (n = 2,077) impaired groups. Study outcomes included cognition and motor functional gains measured by the Functional Independence Measure (FIM) instrument and discharge to the community.

Findings

The average LOS was 8.9, 13.9, and 22.2 days for mild, moderate, and severely(nothing objective about these categories) impaired stroke patients, respectively. After controlling for FIM admission and other important covariates, a longer LOS was associated with a modest increase in cognition gain (β = 0.038, p = .0045) for the moderately impaired patients, and a modest increase in cognition (β = 0.13, p < .0001) and motor gains (β = 0.25, p < .0001) as well as a tendency for discharge to the community (OR = 1.01, 95% CI = 1.00–1.02) among the severely impaired patients. However, a longer LOS showed a negative association with functional gains among the mildly impaired patients as well as discharge to community for both mild and moderately impaired patients.

Conclusion

The association of IRF LOS and patient outcomes varied by stroke impairment severity, positively for more severely impaired patients and negatively for mildly impaired patients.