Rehabilitation Outcomes Among Burn Injury Patients With a Second Admission to an Inpatient Rehabilitation Facility

Quantification of changes in functional capacity and muscle strength in patients: a burn intensive care unit cohort study

BACKGROUND

Regular functional status and muscle strength assessments should be performed with burn victims.

OBJECTIVE

To evaluate the functionality and peripheral muscle strength of burn patients admitted to the hospital.

METHODS

A longitudinal and prospective study was conducted from March to November 2019, including adult burn victims who were admitted to the ICU and discharged from the hospital. Patients were assessed on admission, every 10 days, at discharge from the ICU and from the hospital. Functionality was assessed using the Chelsea Critical Care Physical Assessment (CPAx) and the Functional Independence Measure (FIM). Muscle strength was assessed using the Medical Research Council (MRC) scale and handgrip dynamometry.

RESULTS

41 patients were included, 27 men and 14 women, with a median age of 41 (IQR [28-56]) years, mean TBSA of 19 (SD ± 12) percent, mean Abbreviated Burn Severity Index (ABSI) of 6 (SD ± 2) and the mean ICU time was 29 (SD ± 9) days. The CPAx, FIM and MRC evaluations improved (P < 0.0001) when compared to admission to the ICU and at hospital discharge, while the dynamometry showed no statistical difference. The ABSI only showed an association with the length of stay.

CONCLUSION

The CPAX scale was sensitive to changes in functionality throughout the hospital stay in severely burned patients, in the present study. The assessment of global muscle strength was more sensitive than handgrip strength and the ABSI was associated with length of stay in this population.

Characterization of inpatient rehabilitation outcomes among HIV/AIDS patients: a retrospective cohort study

ABSTRACT Survival time in HIV/AIDS patients has increased as a result of improved treatments, but many acquire functional impairments that may necessitate multidisciplinary medical rehabilitation. In the United States, inpatient rehabilitation facilities (IRF) provide this care, but outcomes are not well described in this population. We used the Uniform Data System for Medical Rehabilitation (UDSMR) database to describe 11,051 HIV/AIDS IRF patients; HIV/AIDS patients were grouped according to the following admission criteria: (1) HIV/AIDS as primary reason for admission (n = 225); (2) HIV/AIDS symptomatic comorbidity (n = 6569); and (3) HIV/AIDS asymptomatic comorbidity (n = 4257). We used standard descriptive statistics to summarize demographic, medical, rehabilitation, and discharge setting characteristics by group. When compared to patients with HIV/AIDS as a comorbidity, primary HIV/AIDS patients had worse outcomes. They made less functional change (25.1 versus 29.8 and 28.9, p < .001), went home less (73.8% versus 74.5% and 77.8%, p < .001) and to an acute care hospital more frequently (18.2% versus 13.9% and 10.1%, p < .001). These findings help to characterize the HIV/AIDS patient population who receive inpatient medical rehabilitation, which helps inform clinical care, and highlight the positive impact IRF care can make to minimize functional disability among chronic HIV/AIDS patients and possibly decrease costs of home health care.

Review of Burn Research for Year 2014

Management of burn injuries requires treatments and interventions from many disciplines. Worldwide, burn patients suffer from physical and psychological challenges that impact their lives socially and economically. In this review, we will highlight a handful of the numerous articles published in multiple areas of burn care. The areas of burn care addressed in the article are: epidemiology; burn resuscitation, critical care, and infection; nutrition and metabolism; pain and rehabilitation; prevention and firefighter safety; psychology; and reconstruction and wounds.