Diabetes prevalence and influence on resource use in Washington state inpatient rehabilitation facilities, 2001 to 2007

Multidisciplinary Diabetes Management and Education Strategies in the Inpatient Rehabilitation Setting

People with diabetes receiving inpatient rehabilitation have multiple unique care needs. Although the condition, event, or disability resulting in admission to an inpatient rehabilitation facility (IRF) may not have a causal relationship with chronic conditions such as diabetes, the condition precipitating referral to IRF care may increase a person's risk for worsening cardiometabolic disease. Furthermore, diabetes management in the IRF setting may be complicated by stress hyperglycemia from illness and/or drug-induced hyperglycemia from the use of glucocorticoids or other offending medications. The availability of a multidisciplinary team of clinicians and therapists in the IRF setting holds great opportunity for development of robust diabetes care and education programs to optimize therapy, teach or reinforce diabetes self-management survival skills, and facilitate safe transitions of care to individuals' next setting of care.

Sarcopenia Is Associated With Reduced Function on Admission to Rehabilitation in Patients With Diabetes

OBJECTIVE

This work aims to estimate the prevalence of sarcopenia and to investigate the association between sarcopenia and functional performance in patients with and without diabetes admitted for inpatient rehabilitation.

MATERIALS AND METHODS

Consecutive patients admitted to the subacute inpatient rehabilitation unit at St Vincent's Hospital Melbourne, Australia (November 2016 to March 2020) were prospectively recruited into this cross-sectional study. Sarcopenia was diagnosed using the European Working Group on Sarcopenia in Older People 2018 algorithm. Participants' functional performance was measured by the total Functional Independence Measure, motor Functional Independence Measure, and the Short Physical Performance Battery. The association between sarcopenia and functional performance was investigated using quantile regression.

RESULTS

Of 300 participants, 49 (16%) had a history of diabetes and 44 (14.7%) were diagnosed with sarcopenia. No significant difference in the prevalence of sarcopenia between patients with or without diabetes was identified (11/49, 22.5% vs 33/251, 13.2%, P = .12). In patients with diabetes, those with sarcopenia had significantly reduced functional performance compared to those without sarcopenia on Functional Independence Measure, motor Functional Independence Measure, and the Short Physical Performance Battery, whereas in patients without diabetes no significant difference between patients with and without sarcopenia were identified for either functional performance measure (all P values for interaction < .005).

CONCLUSIONS

The diagnosis of sarcopenia was associated with a reduced functional performance on admission to inpatient rehabilitation in patients with diabetes, but not in those without diabetes. Further investigation is needed into the progress of patients with dual diagnoses of diabetes and sarcopenia in inpatient rehabilitation.

Prevalence of Risk Factors for Non-Communicable Diseases for New Patients Reporting to Korle-Bu Teaching Hospital

BACKGROUND

The risk factors of Noncommunicable diseases (NCDs) are not routinely monitored, especially among populace reporting to hospitals to detect and also advise on preventive measures, a key strategy to reducing the impact of NCDs on the Health Care System and population.

METHODS

A cross-sectional survey was carried out between the months of May and June, 2010 among a sample representative of the medical and surgical out-patients population to determine the prevalence of certain risk factors of non-communicable diseases (NCDs). Participants (n = 230) were selected by systematic random sampling. Standardised international protocols were used to measure the prevalence of smoking, alcohol consumption, physical inactivity, obesity, raised blood pressure, raised blood glucose and total cholesterol.

RESULTS

The obesity level of the study population was 40.4% with 54% being overweight. Tobacco use among the respondents was 4.8%. Alcohol consumption was 64.8%, with 54.3% of the study population being physically inactive. Almost 48%and 70.9% of the participants consumed fruits and vegetables respectively, at least three days in a week. The prevalence of hypertension was 33.6% for men and 35.2% for women. The prevalence of raised glucose and total blood cholesterol level among the study population was 6.5%. Almost 62% of the participants had a combination of three or more risk factors.

CONCLUSION

The prevalence of the significant risk factors in this study were physical inactivity (54.3%), alcohol consumption (64.8%), overweight (54%), obesity (40.4%) and raised blood pressure (34.3%). Hospitals should therefore include NCD risk factor monitoring as part of routine services.

Comorbid disease in persons with traumatic brain injury: descriptive findings using the modified cumulative illness rating scale

OBJECTIVE

To provide descriptive findings regarding the overall health status and prevalence of medical comorbidities experienced by traumatic brain injury (TBI) patients.

DESIGN

Inception cohort design with cross-sectional follow-up at 1 to 15 years.

SETTING

Rehabilitation hospital.

PARTICIPANTS

Adults (N=258) with moderate to severe TBI.

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURE

The Modified Cumulative Illness Rating Scale is a 14-item rating scale used to indicate health status by rating impairment across 14 different domains.

RESULTS

The TBI sample had lower rates of comorbidities compared with other rehabilitation populations, including stroke and orthopedic samples. The most commonly encountered medical conditions within our sample were eyes, ears, nose, and throat problems, psychiatric or behavioral disturbances, hypertension, and musculoskeletal injury at mild to moderate severity. Prevalence of conditions did not differ by sex, race, or cause of TBI.

CONCLUSIONS

The current TBI sample was relatively healthy with few medical comorbidities. Further, the Modified Cumulative Illness Rating Scale may better be used as a standardized checklist to assess for the presence of co-occurring conditions, given the near absence of conditions in the higher range of severity.