Accepted Manuscript Functional Effectiveness of Inpatient Rehabilitation after Heart Transplantation Saurabh Gupta, MD, Elizabeth Larson, MS, Ankur Garg, M.Tech, Florence John, MD MPH, Mukesh Bansal, PhD, Peter M. Eckman, MD, Roderick Sembrano, MD PII:
S1934-1482(16)00070-8
DOI:
10.1016/j.pmrj.2016.01.015
Reference:
PMRJ 1661
To appear in:
PM&R
Received Date: 22 April 2015 Revised Date:
26 January 2016
Accepted Date: 29 January 2016
Please cite this article as: Gupta S, Larson E, Garg A, John F, Bansal M, Eckman PM, Sembrano R, Functional Effectiveness of Inpatient Rehabilitation after Heart Transplantation, PM&R (2016), doi: 10.1016/j.pmrj.2016.01.015. This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
ACCEPTED MANUSCRIPT
Functional Effectiveness of Inpatient Rehabilitation after Heart Transplantation Saurabh Gupta MD1, Elizabeth Larson MS2, Ankur Garg M.Tech3, Florence John MD MPH4, Mukesh Bansal PhD5, Peter M Eckman MD6 , Roderick Sembrano MD2
M AN U
Correspondence: Saurabh Gupta, MD Clinical Assistant Professor of Medicine University of Minnesota Medical Center, M Health 2450 Riverside Ave Minneapolis, MN 55415 [email protected] Ph: 646-744-5128 Fax: 612-273-4551
SC
RI PT
1: Division of General Internal Medicine, University of Minnesota Medical Center, M Health 2: Division of PM&R, University of Minnesota Medical Center, M Health 3: Indiana University School of Medicine 4: University of Minnesota Medical School 5: Department of systems biology, Columbia University, NY 6: Division of Cardiology, University of Minnesota Medical Center, M Health
AC C
EP
TE D
-The material was not presented at an AAPM&R Annual Assembly. - Funding source: None
ACCEPTED MANUSCRIPT
42 43
Functional Effectiveness of Inpatient Rehabilitation after Heart Transplantation ABSTRACT
RI PT
Background: Heart transplantation (HT) is the treatment of choice for many patients with end-stage Heart Failure (HF) who remain symptomatic despite optimal medical therapy but no study has looked directly into functional improvement of Heart Transplant patients after an Inpatient Rehabilitation Program.
SC
Objective: To determine functional improvement in heart transplant patients who completed an inpatient rehabilitation program.
M AN U
Design: Retrospective study
Setting: An Inpatient Rehabilitation Facility (IRF) associated with a tertiary care hospital.
Patients: Seventeen patients admitted between March 2011 and September 2014 following heart transplantation.
Methods: Demographic, clinical and functional data (admission and discharge
EP
TE D
Functional Independence Measure/ FIM scores) were recorded. Change in FIM scores and FIM efficiency (change in FIM score/length of stay) were analyzed. FIM outcomes for HT patients were compared to regional and national averages for patients undergoing an inpatient rehabilitation program for cardiac debility. As a secondary outcome, we evaluated whether Body Mass Index (BMI) of HT patients had an impact on FIM gains in an IRF. Individual FIM items were analyzed for trends. Results are reported as mean ± standard deviation.
Results: Twelve males and five females with mean age of 61.2±4.5 years were identified. Three patients were readmitted to acute hospital due to complications. For those fourteen patients who completed IRF stay, the mean admission and discharge motor FIM were 51.5 (±14.6) and 74.7 (±12.0) respectively. The mean admission and discharge cognition FIM were 30.9 (±3.2) and 32.9 (±1.7) respectively. The mean total FIM gain was 26.9 ± 13.3, (p
S1934-1482(16)00070-8
DOI:
10.1016/j.pmrj.2016.01.015
Reference:
PMRJ 1661
To appear in:
PM&R
Received Date: 22 April 2015 Revised Date:
26 January 2016
Accepted Date: 29 January 2016
Please cite this article as: Gupta S, Larson E, Garg A, John F, Bansal M, Eckman PM, Sembrano R, Functional Effectiveness of Inpatient Rehabilitation after Heart Transplantation, PM&R (2016), doi: 10.1016/j.pmrj.2016.01.015. This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
ACCEPTED MANUSCRIPT
Functional Effectiveness of Inpatient Rehabilitation after Heart Transplantation Saurabh Gupta MD1, Elizabeth Larson MS2, Ankur Garg M.Tech3, Florence John MD MPH4, Mukesh Bansal PhD5, Peter M Eckman MD6 , Roderick Sembrano MD2
M AN U
Correspondence: Saurabh Gupta, MD Clinical Assistant Professor of Medicine University of Minnesota Medical Center, M Health 2450 Riverside Ave Minneapolis, MN 55415 [email protected] Ph: 646-744-5128 Fax: 612-273-4551
SC
RI PT
1: Division of General Internal Medicine, University of Minnesota Medical Center, M Health 2: Division of PM&R, University of Minnesota Medical Center, M Health 3: Indiana University School of Medicine 4: University of Minnesota Medical School 5: Department of systems biology, Columbia University, NY 6: Division of Cardiology, University of Minnesota Medical Center, M Health
AC C
EP
TE D
-The material was not presented at an AAPM&R Annual Assembly. - Funding source: None
ACCEPTED MANUSCRIPT
42 43
Functional Effectiveness of Inpatient Rehabilitation after Heart Transplantation ABSTRACT
RI PT
Background: Heart transplantation (HT) is the treatment of choice for many patients with end-stage Heart Failure (HF) who remain symptomatic despite optimal medical therapy but no study has looked directly into functional improvement of Heart Transplant patients after an Inpatient Rehabilitation Program.
SC
Objective: To determine functional improvement in heart transplant patients who completed an inpatient rehabilitation program.
M AN U
Design: Retrospective study
Setting: An Inpatient Rehabilitation Facility (IRF) associated with a tertiary care hospital.
Patients: Seventeen patients admitted between March 2011 and September 2014 following heart transplantation.
Methods: Demographic, clinical and functional data (admission and discharge
EP
TE D
Functional Independence Measure/ FIM scores) were recorded. Change in FIM scores and FIM efficiency (change in FIM score/length of stay) were analyzed. FIM outcomes for HT patients were compared to regional and national averages for patients undergoing an inpatient rehabilitation program for cardiac debility. As a secondary outcome, we evaluated whether Body Mass Index (BMI) of HT patients had an impact on FIM gains in an IRF. Individual FIM items were analyzed for trends. Results are reported as mean ± standard deviation.
Results: Twelve males and five females with mean age of 61.2±4.5 years were identified. Three patients were readmitted to acute hospital due to complications. For those fourteen patients who completed IRF stay, the mean admission and discharge motor FIM were 51.5 (±14.6) and 74.7 (±12.0) respectively. The mean admission and discharge cognition FIM were 30.9 (±3.2) and 32.9 (±1.7) respectively. The mean total FIM gain was 26.9 ± 13.3, (p
