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Outcomes of acute inpatient rehabilitation of patients with left ventricular assist devices and subsequent stroke

Mathews, Amy; Goodman, Daniel A.; Rydberg, Leslie

American Journal of Physical Medicine & Rehabilitation: April 16, 2019 - Volume Publish Ahead of Print - Issue - p
doi: 10.1097/PHM.0000000000001200
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Objective To examine the functional outcomes and medical complications of patients with left ventricular assist device (LVAD) implantation and subsequent stroke during comprehensive inpatient rehabilitation.

Design Retrospective cohort study of 21 patients admitted to an inpatient rehabilitation facility between 2009 and 2015. Main outcome measurements include admission and discharge Functional Independence Measure (FIM), length of stay (LOS), and FIM efficiency.

Results The study included 17 male and 4 female patients ages 32-75. Eleven patients (52%) required transfer to an acute care hospital for evaluation. Fifteen patients completed inpatient rehabilitation with median [IQR] length of stay 26 [13.5,34] days (range 7-59 days), median [IQR] FIM gain of 18 [12.5,32], and median [IQR] FIM efficiency of 1.0 [0.6,1.44]. Patients who required transfer to acute care during their course, but ultimately completed inpatient rehabilitation (n=5), demonstrated larger median [IQR] FIM gain (40 [23,42]) and longer median [IQR] LOS (35 [35,42]) compared with patients who completed inpatient rehabilitation without transfer (FIM gain: 15 [9.25,26.5]; LOS: 14.5 [11.5,26.25]).

Conclusion Patients with LVAD implantation and subsequent stroke demonstrate functional gains during acute inpatient rehabilitation programs. A large percent of patients required transfer to acute care.

Department of Physical Medicine and Rehabilitation University of Texas-Southwestern Medical Center, 5323 Harry Hines, Dallas, TX 75390, amy.mathews@utsouthwestern.edu

Shirley Ryan AbilityLab, 355 E. Erie St., Chicago, IL 60611, dgoodman2sralab.org

Shirley Ryan AbilityLab, 355 E. Erie St., Chicago, IL 60611

No financial disclosures or conflicts of interest

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