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Neurological Rehabilitation

(Research Hub Theater) Discharge Disposition and Functional Outcomes for Neuroinvasive West Nile Virus

Friday, November 17, 2023
12:00 PM – 1:45 PM CT
Background and/or Objectives: Discharge location of patients diagnosed with neuroinvasive west nile virus (NIWNV). Improvement of functional status of NIWNV patients admitted to an inpatient rehabilitation facility (IRF).

Design: Retrospective chart review of patients diagnosed with NIWNV. Acute care data included length of stay (LOS), discharge location, and medical diagnostics. IRF data collected included deficits/symptoms, comorbid conditions, LOS, discharge location. Functional disability and cognitive scores were evaluated by Medicare mobility (GG) scale and Functional Independent Measure (FIM) scale. Approved by HonorHealth IRB.

Setting: Metropolitan acute care hospital system and stand alone IRF.

Participants: Patients diagnosed with NIWNV

Interventions: not applicable.

Main Outcome Measures: Discharge locations and functional scales

Results: 51/421 (63% males, 71±14 years old) patients were identified and reviewed. Acute care mean LOS was 10.4 days ±6.5, 88 discharged to IRF, 90 discharge home, 61 to SNF, 15 to LTAC, 51 with home-health services, and 40 expired. 67 patients (80% male, 70 ± 13 years old) were identified and reviewed from a local IRF. Mean LOS was 13 days ± 7 and 75% were discharged to the community. GG scale showed a mean admission score of 46 ± 15, mean discharge score of 78 ± 20, with a mean change of 30 ± 13.

Conclusions: Previous studies have shown functional outcomes of NIWNV from IRF. These studies often need years to reach case numbers seen in this study. This study is the largest population of NIWNV in the shortest time frame documented. Additionally, incidence of autonomic dysfunction, such as bladder impairments and blood pressure dyscrasia have not been highlighted. Preliminary data suggests that intensive rehabilitation can improve functional outcomes in this patient population. Initially we believed patients would have cognitive improvement, however those with significant cognitive impairments showed little progress during acute rehabilitation. Older patients with multiple comorbidities showed the smallest improvements in functional scales.