{"title":"Baseline Nutritional Status and Rehabilitation Progress in Individuals Requiring Inpatient Rehabilitation: A Retrospective Cohort Study","authors":"Hideki Arai MD, PhD , Syuya Okada PT , Tatsuyuki Fukuoka SLP, PhD , Masafumi Nozoe PT, PhD , Kuniyasu Kamiya PT, PhD , Satoru Matsumoto MD","doi":"10.1016/j.arrct.2024.100362","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><p>To evaluate the relationships between baseline nutritional status, medical events (MEs), and rehabilitation outcomes in individuals undergoing inpatient rehabilitation (IR).</p></div><div><h3>Design</h3><p>A retrospective single center cohort study.</p></div><div><h3>Setting</h3><p>An IR ward.</p></div><div><h3>Participants</h3><p>This study included 409 patients (mean age, 80 years; men, 170 [42%]) undergoing IR for hospital-associated deconditioning, neurologic disorders, or musculoskeletal diseases. Participants were grouped according to the Controlling Nutritional Status score at admission: normal nutrition (NN): 0 to 1, mild malnutrition (MM): 2 to 4, and moderate/severe malnutrition (M/SM): 5 to 12.</p></div><div><h3>Interventions</h3><p>None.</p></div><div><h3>Main Outcome Measures</h3><p>The primary outcomes included MEs leading to death or acute illness requiring transfer to other hospitals for specialized treatments. The secondary outcomes were the rehabilitation efficiency scores (changes in Functional Independence Measure [FIM] score divided by length of stay) for motor function (FIM-M) and cognitive function (FIM-C).</p></div><div><h3>Results</h3><p>Among the 409 participants, 300 (73%) were malnourished at admission. The adjusted hazard ratios (95% confidence interval) for MEs in the MM and M/SM groups relative to the NN group were 1.48 (0.67-3.27) and 0.98 (0.34-2.81), respectively. No significant differences were observed among the 3 groups in FIM-M efficiency scores (mean ± SD, NN: 0.49±0.51 vs MM: 0.41±0.57 vs M/SM: 0.44±1.06, <em>P</em>=.7) or FIM-C efficiency scores (0.04±0.06 vs 0.04±0.06 vs 0.08±0.4, <em>P</em>=0.1). Analysis of covariance showed no significant association between MM or M/SM group and FIM-M efficiency score (beta coefficient = -0.038, <em>P</em>=.6; beta coefficient = 0.15, <em>P</em>=.1, respectively) or FIM-C efficiency score (<em>beta coefficient</em> = 0.004, <em>P</em>=.8; <em>beta coefficient</em> = 0.047, <em>P</em>=.08, respectively).</p></div><div><h3>Conclusion</h3><p>No significant associations were observed between the baseline nutritional status and MEs, FIM-M efficiency score, or FIM-C efficiency score in individuals undergoing IR.</p></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"6 3","pages":"Article 100362"},"PeriodicalIF":1.9000,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590109524000600/pdfft?md5=127a5be27861074f2c6a02c49b209b50&pid=1-s2.0-S2590109524000600-main.pdf","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Archives of rehabilitation research and clinical translation","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2590109524000600","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"REHABILITATION","Score":null,"Total":0}
引用次数: 0
Abstract
Objective
To evaluate the relationships between baseline nutritional status, medical events (MEs), and rehabilitation outcomes in individuals undergoing inpatient rehabilitation (IR).
Design
A retrospective single center cohort study.
Setting
An IR ward.
Participants
This study included 409 patients (mean age, 80 years; men, 170 [42%]) undergoing IR for hospital-associated deconditioning, neurologic disorders, or musculoskeletal diseases. Participants were grouped according to the Controlling Nutritional Status score at admission: normal nutrition (NN): 0 to 1, mild malnutrition (MM): 2 to 4, and moderate/severe malnutrition (M/SM): 5 to 12.
Interventions
None.
Main Outcome Measures
The primary outcomes included MEs leading to death or acute illness requiring transfer to other hospitals for specialized treatments. The secondary outcomes were the rehabilitation efficiency scores (changes in Functional Independence Measure [FIM] score divided by length of stay) for motor function (FIM-M) and cognitive function (FIM-C).
Results
Among the 409 participants, 300 (73%) were malnourished at admission. The adjusted hazard ratios (95% confidence interval) for MEs in the MM and M/SM groups relative to the NN group were 1.48 (0.67-3.27) and 0.98 (0.34-2.81), respectively. No significant differences were observed among the 3 groups in FIM-M efficiency scores (mean ± SD, NN: 0.49±0.51 vs MM: 0.41±0.57 vs M/SM: 0.44±1.06, P=.7) or FIM-C efficiency scores (0.04±0.06 vs 0.04±0.06 vs 0.08±0.4, P=0.1). Analysis of covariance showed no significant association between MM or M/SM group and FIM-M efficiency score (beta coefficient = -0.038, P=.6; beta coefficient = 0.15, P=.1, respectively) or FIM-C efficiency score (beta coefficient = 0.004, P=.8; beta coefficient = 0.047, P=.08, respectively).
Conclusion
No significant associations were observed between the baseline nutritional status and MEs, FIM-M efficiency score, or FIM-C efficiency score in individuals undergoing IR.
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