Factors influencing the functional outcome at discharge: a retrospective study on a large sample of patients admitted to an intensive rehabilitation unit

OBJECTIVE: Functional outcome represents the most central objective of rehabilitation programs. Understanding which factors could affect functional status at discharge is crucial for the planning of appropriate treatments in both neurological and orthopedic patients. The aim of this study was to investigate which clinical and demographic variables, collected at the patient's admission, could influence the functional outcome, assessed by the modified Barthel Index (mBI), at discharge.

DESIGN: A retrospective study was conducted on a large cohort (n=3,548) of orthopedic and neurological patients. Functional, demographic and clinical records at patient admission and the mBI score at discharge were collected. General linear model analysis was performed to assess the influence of these variables on functional outcome at discharge.

RESULTS: The results reported a significant effect of mBI at admission (p-value<0.0001), age (p-value<0.0001) and time from the acute event (p-value<0.0001) on mBI at discharge. Moreover, the disease type (neurological or orthopedic) adjusted by gender (male or female) and presence of different impairments (cognitive and behavioral impairments) and complications (hypertension and cardiovascular diseases) significantly influenced the mBI at discharge (p-value<0.05) (R=0.497). No significant interactions between other factors were found (p-value>0.05).

CONCLUSION: Several prognostic factors should be considered when planning an appropriate tailored rehabilitation program.