(Research Hub Theater) Impacts of Morphine Milligram Equivalents in the 5 Days Prior to Acute Inpatient Rehab

Objective: Many individuals require opiate medications in the acute hospital setting. Most patients come to acute inpatient rehabilitation (AIR) post-operatively and pain is managed with opiates in the acute setting. Our objective was to determine the significance of opioids on outcomes in acute inpatient rehab.

Design: A retrospective cohort study of adult patients from UNC rehab hospitals from May 2022 to November 2022.

Setting: Acute Inpatient Rehabilitation

Participants: Restricted the analysis to patients 18-65 in age who were admitted to UNC rehab hospitals from May 01, 2022 to November 30, 2022. Excluded patients who had prior history of opiate abuse or dependence and patients who came to AIR from non-UNC affiliated hospitals.

Interventions: Not applicable

Main Outcome Measures: We employed multivariable linear regression to compare outcome measures with MME in the 5-day period prior to AIR. Determine difference in length of stay between patients who took < 30mme/day in 5 days prior to rehab and ≥30mme/day in 5 days prior.

Results: The data from 235 patients has been abstracted and validated from the total of 291 patients in the cohort. Data was analyzed using a t-test comparing length of stay in patients who received < 30mme/day and those who received ≥30mme/day. On average patients receiving ≥30mme/day were in acute inpatient rehab for 1 day more when compared to the group < 30mme/day (95% CI 12.7 - 16.2). Multivariable linear regression of MME in the 5 days prior to admission to AIR on length of stay (p=0.88), disposition from rehab (p=0.41) and 90 day readmission (p=0.38).

Conclusions: MME in the days before rehab has no statistical significance on outcomes related to length of stay, 90 day readmission or disposition at discharge. Many factors may contribute to these outcome measures and further research is needed to investigate this.