入住住院康复设施的 COVID-19 存活者的患者特定因素与功能进展之间的关系

Pm & R Pub Date : 2024-05-02 DOI:10.1002/pmrj.13187
Sean Dreyer, Christopher Lewis, Kyle Fahey, Hannah Martin, Larissa Pavone, Sofia Anastasopoulos, Gaurish Sohi, Leslie Rydberg, Prakash Jayabalan
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摘要

背景因严重急性COVID-19感染而住院的幸存者面临着严重的功能障碍,需要在出院回家之前到住院康复设施(IRF)接受强化康复治疗。目前仍缺乏对因COVID-19相关损伤而入住IRF的患者的功能预后以及与患者特异性因素之间关系的大型队列研究。目的描述因COVID-19相关衰弱而入住IRF的患者的功能预后,并调查功能预后与患者特异性因素之间的关系。干预措施不适用。主要结果测量主要结果包括从入院到出院的住院康复期间GG自理和移动活动分量表以及功能独立性测量评分的变化。线性回归分析用于将功能变化与人口统计学、医学和住院特异性因素联系起来。次要结果包括从IRF出院的目的地。结果分析包括因COVID-19相关康复需求而入住IRF的n = 362名患者。该组患者的行动能力、自理能力和认知能力的综合评分均有明显改善(分别为216.0%、174.3%和117.6%)。与功能改善相关的患者特异性因素包括年龄、体重指数、病前就业状况、糖尿病和心脏病史、急性期接受的药物治疗以及入住IRF时的肌肉力量。在患者的特异性因素和功能改善之间发现了许多重要的关联,这支持对这些因素进行进一步的调查,因为这些因素可能是COVID-19相关功能障碍患者在IRF中功能改善的预测因素。
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The relationship between patient‐specific factors and functional progression of COVID‐19 survivors admitted to an inpatient rehabilitation facility
BackgroundSurvivors of hospitalization for severe acute COVID‐19 infection faced significant functional impairments necessitating discharge to inpatient rehabilitation facilities (IRFs) for intensive rehabilitation prior to discharge home. There remains a lack of large cohort studies of the functional outcomes of patients admitted to IRFs with COVID‐19‐related impairments and the relationship to patient‐specific factors.ObjectiveTo characterize functional outcomes of patients admitted to IRFs for COVID‐19‐related debility and to investigate associations between functional outcomes and patient‐specific factors.DesignMultisite retrospective cohort study.SettingMultiple IRFs in a large urban city.ParticipantsAdult patients admitted to IRFs for rehabilitation after hospitalization for acute COVID‐19 infection.InterventionsNot applicable.Main Outcome MeasuresPrimary outcomes included change in GG Self‐Care and Mobility Activities subscales and Functional Independence Measure scores from admission to discharge from inpatient rehabilitation. Linear regression analysis was used to relate functional changes to demographic, medical, and hospitalization‐specific factors. Secondary outcomes included discharge destination from the IRF.ResultsThe analysis included n = 362 patients admitted to IRFs for COVID‐19‐related rehabilitation needs. This cohort showed significant improvements in mobility, self‐care, and cognition congregate scores (216.0%, 174.3%, 117.6% respectively). Patient‐specific factors associated with functional improvement, included age, body mass index, premorbid employment status, history of diabetes and cardiac disease and medications received in acute care, and muscle strength upon admission to IRF.ConclusionsPatients admitted to inpatient rehabilitation for COVID‐19‐related functional deficits made significant functional improvements in mobility, self‐care, and cognition. Many significant associations were found between patient‐specific factors and functional improvement, which support further investigation of these factors as possible predictors of functional improvement in an IRF for COVID‐19‐related deficits.
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