Poster 74: Relationship of Anemia on Inpatient Rehabilitation Outcomes

Abstract

Objective: To assess the impact of anemia as a comorbidity on discharge functional outcomes among inpatient rehabilitation participant. Design: Sequential chart review. Setting: Inpatient rehabilitation patients from January 2004 top August 2004. Participants: Consecutive sample of charts were selected for review of all patients admitted to the inpatient acute rehabilitation unit with various impairments like stroke, orthopedic disorders, debility, amputation, and other neurologic disorders. Interventions: Not applicable. Main Outcome Measures: Admission impairments, discharge hemoglobin (Hgb), demographics, and FIM instrument were collected. The FIM includes admission and discharge scores for self-care, locomotion, and cognition. Anemia was defined as a discharge Hgb <11.5g/dL. Improvements in FIM scores from admission to discharge of anemic and nonanemic patients were compared. Results: Of 481 charts, 5% were excluded from the analysis because of incomplete data. Average age was 72 years, the sex and age distributions remained similar for both groups. Mean lengths of stay for the nonanemic group and the anemic group was 11 and 10.5 days, respectively. 53% of the subjects were anemic. The anemic group had more patients with orthopedic disorder (16%), whereas the other group had more stroke patients (27%). The nonanemic group had significant improvements in their FIM discharge scores (21%, P=.03) compared with the anemic group (16%). Improvement in FIM scores in the group with Hgb >11.5g/dL (21%) was significant compared with the group with Hgb <10.0g/dL (15%, P=.03), after adjusting for associated admission impairments and age. Conclusions: Anemia (Hgb <11.5g/dL) in this study sample was a significant independent predictor of functional outcomes during rehabilitation stay after adjusting for various admission impairments. There was a trend toward improvement in the functional outcome as the Hgb improved from below 10.0g/dL to >11.5g/dL. No further improvement was seen once the Hgb was >13g/dL. It remains to be determined if anemia correction will lead to improvement in rehabilitation outcomes.