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General Rehabilitation

Inpatient Rehabilitation Improves Physical Outcomes for Older Adults after Burn Injury

(Research Hub Theater) Inpatient Rehabilitation Improves Physical Outcomes for Older Adults After Burn Injury

Thursday, November 16, 2023

5:00 PM – 7:00 PM CT

Primary Author(s)

Samuel A. Moshofsky, MD

PM&R Resident Physician
University of Texas Southwestern PM&R Program
Dallas, Texas

Co-Author(s)

KK

Karen Kowalske, MD

Professor, Physical Medicine & Rehabilitation
University of Texas Southwestern Medical School PM&R Program
Dallas, Texas
AB

Alyssa Bamer, MPH

Research Scientist
University of Washington
Golden, Colorado
LS

Lauren Shepler, MPH

Research Program Manager
n/a
Boston, Massachusetts
SM

Samuel Mandell, MD, MPH

Associate Professor
n/a
Dallas, Texas
JS

Jeffrey C. Schneider, MD

Associate Professor
Spaulding Rehabilitation Hospital
Boston, Massachusetts
KS

Kyra Solis-Beach, Other

Research Coordinator
University of Texas Southwestern Medical Center
Dallas, Texas
HY

Haig Yenikomshian, MD

Assistant Professor of Plastic Surgery
Keck School of Medicine of the University of Southern California
Los Angeles, California
CR

Colleen M. Ryan, MD

Professor of Surgery
Harvard Medical School
Boston, Massachusetts
GC

Gretchen J. Carrougher, MSN

Research Nurse Supervisor
University of Washington
Seattle, Washington

Objective: Determine whether discharge to Inpatient Rehabilitation (IPR) is associated with decreased mortality, improved physical outcomes, and/or improved mental health outcomes compared to discharge to Skilled Nursing Facility (SNF) for older adults discharged after acute burn injuries.

Design: Multi-center retrospective cohort study.

Setting: Burn Model Systems Centers.

Participants: 237 adults age 55 and older who were admitted to a Burn Model Systems hospital and discharged to either IPR or SNF. Those who were discharged directly home or died in the hospital were excluded from this study.

Interventions: Admission to inpatient rehabilitation which includes, on average, 3 hours of physical, occupational, and speech therapy (if necessary) per day.

Main Outcome Measures: Mortality, The Veterans RAND 12 Item Health Survey (VR-12), 12-item Short Form Survey (SF-12). Both VR-12 and SF-12 contain Physical Component Score (PCS) and Mental Component Score (MCS).

Results: On average, the group discharged to IPR scored 6.9 points higher on the Physical Component Score (PCS) of the SF-12 and VR-12 compared to the group discharged to SNF at 1 year (p = 0.014). Discharge to IPR, compared to discharge to SNF, was not associated with changes in Mental Component Scores (MCS) scores or mortality at 1 year after discharge.

Conclusions: For older adults hospitalized with acute burn injuries, discharge to Inpatient Rehabilitation is associated with significant improvement in physical outcomes when compared to discharge to Skilled Nursing Facility. Although no differences were found in mortality or mental health outcomes, improvement in physical outcomes alone can positively impact older adults’ functional status, ability to live independently, and self-confidence, among others. Older adults should be considered candidates for inpatient rehabilitation after acute burn injuries to improve their physical function with goals of achieving more functional independence.