114A Cohort Study Characterising Admissions and Evaluating Discharge Outcomes from a Care of the Older Person Rehabilitation Unit

Abstract

Background: For older people following an acute hospital admission, multidisciplinary inpatient rehabilitation can improve functional independence and reduce institutionalisation. It can be difficult to predict who may best benefit from this limited resource. We aimed to identify baseline characteristics of a cohort of admissions to a rehabilitation unit and evaluate outcome measures. Methods: This was a retrospective cohort study. Data was collected on all admissions to a medical rehabilitation unit over six months. Demographic, admission and discharge outcome measures were analysed using the statistical program SPSS. Differences in outcome measures were assessed in those less than and greater than 80 years. Results: Data was analysed on 60 of 82 admissions over this timeframe (9 patients transferred back to the acute hospital, 5 incomplete data and 8 not yet discharged). Mean (SD) age was 81(9) years with 58% female (N = 35). 62% (N = 37) had cognitive impairment, which was defined both by cognitive impairment on objective assessment and the identification of cognitive deficits impacting on function during rehabilitation. Mean (SD) length of stay was 17 (8) days with 98% (N = 59) discharged home; 52% (N = 31) living alone. 65% (N = 35) were ≥80 years. While there was no difference on admission between Timed Up and Go (TUAG) in those less than and greater than 80 years, on discharge those ≥80 years had a significantly higher TUAG, mean (SD) 29 (17) versus 19 (10) p = 0.023. Falls Risk Score (FRS) was also higher 46% (N = 18) having a moderate/high risk compared to 14% (N = 3) in the younger group (p 0.055). There was no significant difference between discharge Berg Balance score, Barthel score or FIM/FAM scores between age-groups. Conclusion: Older patients, including those with cognitive impairment and regardless of age benefit from rehabilitation in terms of improved functional outcomes and mobility. These findings support proper resourcing of in-patient and community rehabilitation.