Anemia and Rehabilitation Outcomes in Patients Undergoing Convalescent Rehabilitation

Abstract

ObjectiveAssessment of the association between anemia and recovery of physical disability in patients with functional impairment. DesignA retrospective cohort study. SettingA convalescent rehabilitation ward. ParticipantsThe subjects were patients undergoing convalescent rehabilitation due to neurologic disease, musculoskeletal disorders, or hospital-associated deconditioning. Patients were classified into 3 groups (no anemia; mild anemia [men: hemoglobin of 11.0-12.9 g/dL; women: hemoglobin of 11.0-11.9 g/dL]; and moderate/severe anemia [hemoglobin < 11.0 g/dL]) based on hemoglobin levels. InterventionsNot applicable. Main Outcome MeasuresThe study outcomes were functional independence measures for motor function (FIM-M) score at discharge, changes in the FIM-M score between hospital admission and discharge, length of stay, and FIM-M efficiency score (change in FIM-M score divided by length of stay). A linear regression model was constructed to explore the association of anemia with the FIM-M efficiency score. As a subgroup analysis, we constructed a linear regression model to explore the association of anemia with the FIM-M efficiency score in patients with or without stroke. ResultsOf 376 consecutive patients with a mean age of 80 years, 258 (69%) had mild or moderate/severe anemia. There were no significant differences between the 3 groups in the FIM-M score at discharge, changes in the FIM-M score, length of stay, and FIM-M efficiency score. A multiple linear regression model showed that the FIM-M efficiency score was not associated with anemia (mild anemia group: β=−0.02, P=.8; moderate/severe anemia group: β=−0.005, P=.9). In the subgroup analysis of patients with or without stroke, the multiple regression model also showed no significant association between anemia and FIM-M efficiency score in each group. ConclusionsAnemia on admission was common among patients in a convalescent rehabilitation ward but was not associated with improvement of FIM-M after rehabilitation.