Frequency and Characteristics of Medical Complications in Rehabilitation Settings: A Scoping Review.
Elyse Ladbrook, Stephane Bouchoucha, Ana Hutchinson
PMID 36287186WHAT IT FOUND
People in inpatient rehabilitation often experienced medical complications, especially infections and neurological changes.
Some needed transfer back to acute care. This review maps how common they are, not whether any treatment prevents them.
Key findings
01Across 24 studies, the reported incidence of at least one medical complication varied from 3.4% to 96.8%.
02Infections and non-infectious neurological changes were the most commonly reported complications, and hospital-acquired events included falls, pressure injuries, venous thromboembolism and adverse drug events.
03Across 30 studies, reported return-to-acute-care rates ranged from 2.89% to 52.38%; infection was the most common reason in 12 studies.
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 scoping review, so it mapped how often complications were reported. It did not test whether any treatment, monitoring model or pathway prevents complications. The included studies used different populations, settings, definitions and outcome measures. That made the reported rates very different across studies. Most studies were observational and relied on retrospective analysis of administrative data, so they could not control for all factors that may have caused the complications. The review could not tell whether complications were due to worsening of a pre-existing condition, the reason for admission, a hospital-acquired event or a new condition. Quality appraisal was done, but studies were not excluded based on it, so methodological weaknesses may remain in the included evidence. Risk factors were inconsistently analysed, and many studies presented descriptive rather than analytical data. Findings about death were reported in only 8 studies and cannot show that complications alone caused death. The review included English and French studies from 2000 to 2021, so it may not cover all relevant literature in other languages or years.
The easy way to misread this
Do not read the wide range of reported complication rates as a single expected rate for your patients. The studies used different populations, settings and definitions, and this review did not show what prevents complications.