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Impact of Pressure Ulcers on Outcomes in Inpatient Rehabilitation Facilities

Wang, Hua PhD; Niewczyk, Paulette MPH, PhD; DiVita, Maggie MS; Camicia, Michelle MSN, CRRN; Appelman, Jed PhD; Mix, Jacqueline MPH; Sandel, Mary Elizabeth MD

American Journal of Physical Medicine & Rehabilitation:
doi: 10.1097/PHM.0b013e3182a92b9c
Original Research Articles
Abstract

Objective: The aim of this study was to examine the impact of pressure ulcers on inpatient rehabilitation facility (IRF) outcomes.

Design: This is a retrospective analysis of the IRF data in the United States from the Uniform Data System for Medical Rehabilitation between 2009 and 2011. The study sample included 2902 pairs of pressure ulcer and pressure ulcer–free patients upon IRF admission, matching on age at admission, sex, impairment groups, and comorbidity tier measures. The study outcomes were cognition and motor functional gains measured by the Functional Independence Measure instrument, IRF length of stay, and discharge to the community.

Results: The mean pressure ulcer prevalence upon IRF admission was 5.23%. After controlling for other covariates under study, the pressure ulcer group had a lower motor gain (20.12 vs. 21.58, P < 0.0001), had a longer length of stay (16.5 vs. 15.5, P < 0.0001), and were less likely to be discharged to the community after IRF stay (odds ratio, 0.72; 95% confidence interval, 0.62–0.84) than the patients without a pressure ulcer.

Conclusions: The presence of a pressure ulcer among the patients seen in United States IRFs had no impact on cognition functional gain but was associated with a minor lower motor gain, a longer IRF length of stay, and lower odds of being discharged to the community.

Author Information

From the Kaiser Foundation Rehabilitation Center, Vallejo, California (HW, MC, JA); Uniform Data System for Medical Rehabilitation, Amherst, New York (PN, MD, JM); and University of California, Davis (MES).

All correspondence and requests for reprints should be addressed to: Hua Wang, PhD, Kaiser Foundation Rehabilitation Center, 975 Sereno Dr, Vallejo, CA 94589.

Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article.

© 2014 by Lippincott Williams & Wilkins