The Impact of Comorbidities and Complications on Burn Injury Inpatient Rehabilitation Outcomes

Objective To examine the impact of comorbidities and complications on burn inpatient rehabilitation facilities (IRF) outcomes. Design A retrospective cross-sectional study. Setting Inpatient rehabilitation hospitals. Patients A total of 4572 patients with a primary diagnosis of burn injury from the...

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Bibliographic Details
Published in:PM & R 2013-02, Vol.5 (2), p.114-121
Main Authors: Schneider, Jeffrey C., MD, Gerrard, Paul, MD, Goldstein, Richard, PhD, DiVita, Margaret A., MS, Niewczyk, Paulette, MPH, PhD, Ryan, Colleen M., MD, Kowalske, Karen, MD, Zafonte, Ross, DO
Format: Article
Language:English
Subjects:
Burns - epidemiology
Burns - physiopathology
Burns - rehabilitation
Cross-Sectional Studies
Female
Follow-Up Studies
Humans
Inpatients
Length of Stay
Male
Middle Aged
Physical Medicine and Rehabilitation
Prognosis
Recovery of Function
Rehabilitation Centers
Retrospective Studies
Survival Rate - trends
United States - epidemiology
Wound Infection - epidemiology
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Summary:Objective To examine the impact of comorbidities and complications on burn inpatient rehabilitation facilities (IRF) outcomes. Design A retrospective cross-sectional study. Setting Inpatient rehabilitation hospitals. Patients A total of 4572 patients with a primary diagnosis of burn injury from the Uniform Data System for Medical Rehabilitation database from 2002 to 2010. Methods or Interventions Regression analyses were used to determine whether 3 different comorbidity measures (Charlson Comorbidity Index, Elixhauser Comoribidity Index, Centers for Medicare and Medicaid Services Comorbidity Tiers) and 1 complication measure improved the predictive model (c-statistic) for each outcome measure. Main Outcome Measurements Community discharge, Functional Independence Measure (FIM) gain, length of stay efficiency, transfer to acute care within the first 3 days of IRF stay, and transfer to acute care for all time periods. Results For all outcomes, there was no difference between the Standard Model and the models that include the comorbidity and complication variables as measured by the c-statistic confidence intervals. Conclusions Comorbidities and complications did not significantly affect burn IRF outcomes. Future research is needed to examine the impact of comorbidities and complications on outcomes of other IRF populations to better understand the implications for current and future health care policy.
ISSN:1934-1482
1934-1563
DOI:10.1016/j.pmrj.2012.07.014