Discharge destination and long-term outcomes in patients with two or more non-weightbearing limbs receiving intensive allied health therapy
Jason Pereira1, Asher Kirk1,2, Melissa Webb1,3, Lara Kimmel1,2,31Physiotherapy Department, The Alfred Hospital, Melbourne, Victoria, Australia2Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, Victoria, Australia3Allied Health Executive, The Alfred Hospital, Melbourne, Victoria, Australia
Abstract
BACKGROUND: Inpatient rehabilitation (IPR) is associated with significant financial burden to the hospital system and can lead to poorer outcomes for patients with isolated lower limb orthopaedic injuries when compared to discharge home. The aim of this study was to evaluate IPR admission rates and long-term outcomes of patients with ≥ 2 non-weightbearing (NWB) limbs following trauma.
METHODS: Patient demographics, hospital and long-term outcomes were collected for patients undergoing intensive therapy admitted to The Alfred trauma ward between November 2020 – August 2021. Multi-variable regression analysis was performed to determine factors associated with discharge to IPR and residence at 6 and 12 months.
RESULTS: Ninety-one patients had ≥ 2 NWB limbs. More than half (51%) of patients with ≥ 2 NWB limbs were discharged home. Patients who were admitted to ICU were more likely to be discharged to IPR (Adjusted OR = 3.73). Patients who were discharged home reported better levels of mobility, pain & activity than those who were discharged to IPR. Comparatively, there was no difference in anxiety or disability at 6 or 12 months between groups. There was no association with age, funding status or injury severity on residence at 6 and 12 months.
CONCLUSION: Admission to ICU is the only factor associated with discharge to IPR for patients with ≥ 2 NWB limbs following trauma. Patients who discharged directly home from the acute hospital with ≥ 2 NWB limbs may have improved pain and mobility at 6 months compared to those discharged to IPR.
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