Factors associated with the recovery of activities of daily living after hospitalization for acute medical illness: a prospective cohort study.
Ryohei Goto, Hiroki Watanabe, Madoka Tsutsumi and 3 others
PMID 27821931WHAT IT FOUND
Longer time from illness onset to starting rehabilitation was associated with poorer recovery of daily activities.
Among patients who had been independent before illness, better cognition was associated with better recovery; among those partially dependent, better nutrition was associated with better recovery.
Key findings
01Longer time from illness onset to start of rehabilitation was associated with lower odds of better recovery in both groups split by pre-illness independence.
02Higher cognitive score at rehabilitation start was associated with higher odds of better recovery among patients who had been independent before onset.
03Higher nutritional score at rehabilitation start was associated with higher odds of better recovery among patients who had been partially dependent before onset.
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 an observational cohort, not a trial, so it cannot prove that starting rehabilitation earlier causes better recovery. It included only patients who received rehabilitation, and the authors state no adjustment was made for disease severity, so selection bias is possible. It was done at one center, so results may not apply to other hospitals or patient groups. The authors state amount of rehabilitation did not differ between recovery groups, but that does not separate the effect of timing from other care.
The easy way to misread this
Do not conclude that starting rehabilitation earlier will improve recovery. This was an observational study, and patients were not randomly assigned to earlier or later rehabilitation.