ArticlePM & R : the journal of injury, function, and rehabilitation2020
Inpatient Rehabilitation Delirium Screening: Impact on Acute Care Transfers and Functional Outcomes.
Article in PM & R : the journal of injury, function, and rehabilitation, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed, 17 citations in OpenAlex.
- The Association Between Delirium Upon Admission to a Rehabilitation Hospital and Motor Rehabilitation Outcomes Among Hip Fracture Surgery Patients: A Historical Cohort Study.Journal of clinical medicine · 2024Article
- Gabapentinoids-Related Delirium Adverse Events: A Real-World Study from 2004 to 2022 Based on FAERS.Journal of pain research · 2024Article
- Association of delirium and spatial neglect in patients with right-hemisphere stroke.PM & R : the journal of injury, function, and rehabilitation · 2023Article
- Prevalence and features of delirium in older patients admitted to rehabilitation facilities: a multicenter study.Aging clinical and experimental research · 2022Article
- Article
Corrections and comments
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Authors and funding
3 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundDelirium is well studied in the acute care setting, but there is limited understanding of its impact in the postacute care setting, particularly in the inpatient rehabilitation facility (IRF).
objectiveTo investigate the prevalence and related outcomes of delirium in the IRF setting, particularly patients' transfers to acute care hospitals.
designRetrospective cohort study.
settingA freestanding IRF.
participantsPatients discharged from an IRF between January 2016 and December 2016 (12 months).
interventionsNot applicable.
main outcome measuresTransfer to acute care hospitals, motor and cognitive Functional Independence Measures (FIM), length of stay, discharge disposition.
resultsA total of 1567 patients (53.9% female, mean age 72.9 ± 13.9) were included in the analysis. Positive scores were found among 142 (9.1%) patients on a 3-Minute Diagnostic Interview for Confusion Assessment Method (3D-CAM), indicating delirium on admission. Fifty-nine (3.8%) were unscorable on 3D-CAM. Twice as many delirium patients were transferred to acute care hospitals compared to non-delirium patients (22.5% vs. 10.8%, P < .001). Multivariate logistic regression showed that, for patients with 3D-CAM positive scores, there was an increased risk of transfers to acute care hospitals at an odds ratio of 1.61 (1.03-2.53, P = .04) after adjusting for age, gender, neurological diagnosis, and motor FIM score. The delirium group also showed lower gains in motor function, increased lengths of stay, and reduced discharges to home when compared to the non-delirium group (P < .001).
conclusionsThis study finds that delirium on admission to an IRF is associated with worsened outcomes related to function, length of stay, discharge status, and transfer to acute care hospitals. Positive delirium screening is an independent predictor for transfer to acute care hospitals from an IRF. Early identification of delirium is recommended in order to mitigate preventable transfers.
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