Acute Inpatient Rehabilitation Functional Outcomes and Disposition After Liver Transplant.
Meghan E Willoughby, Jacob L Ramsey-Morrow, Kyle A Littell and 1 others
PMID 39006115WHAT IT FOUND
After liver transplant, 107 patients averaged a 35.7-point FIM gain on the 18-to-126 FIM scale, and 83% ultimately discharged to community.
With no comparison group, this cannot show rehabilitation caused the gains.
Key findings
01The 107 patients had a mean admission FIM of 61.5, a mean discharge FIM of 97.2, and a mean FIM change of 35.7.
02Most patients, 83.2%, were discharged to community, and 4.8% were discharged to SNF.
0337.4% of patients returned to acute care, and 12.1% did not complete rehabilitation after returning to acute care.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
This was a retrospective descriptive chart review, not a controlled trial, so it cannot show that rehabilitation caused the FIM gains. The sample was 107 patients from a single freestanding rehabilitation facility, so results may not apply to other institutions or acute in-hospital rehabilitation units. Patients were identified from admissions between 2014 and 2018, and some had an extended acute-care stay of up to 6 months before transfer. The study counted encounters as well as patients, so some patients had multiple rehabilitation admissions; 143 encounters were used for return-to-acute-care reasons. FIM has known limitations, including possible over- or underestimation of abilities and ceiling effects. The authors state that no strict causality can be concluded from the results.
The easy way to misread this
Do not treat the 35.7-point mean FIM gain as proof that acute rehabilitation caused improvement. There was no comparison group, and the results come from a single facility from 2014 to 2018.