Quality indicators prospectively associated with falls in inpatient rehabilitation facilities.

IF 2.2 4区医学 Q1 REHABILITATION

American Journal of Physical Medicine & Rehabilitation Pub Date : 2024-09-16 DOI:10.1097/PHM.0000000000002625

Jonathan Robert Wright, Jamie D'Ausilio, Thomas Cappaert, Jeffery D Lau

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引用次数: 0

Abstract

Objective: Retrospective studies suggest quality indicators (QI) are associated with falls in inpatient rehabilitation facilities (IRFs), but this claim has not yet been validated prospectively. The aim of this study was to analyze the associations between QI codes and falls in a prospective sample.

Design: For this prospective observational cohort study, we followed 658 patients from 4 IRFs who were consecutively admitted and discharged over a 6-month period. On admission, we collected patients' QI codes, and then, tracked whether they fell during their IRF stay.

Results: Univariable logistic regressions revealed that most individual QI items for communication, self-care, and mobility were significantly associated with falls. In a multivariable model with 6 different QI items, only patients' performance going up and down 1 step was significantly associated with falls. To explain this finding, we investigated the relationships between these QI items and found 3 of them to be highly correlated.

Conclusions: Most individual QI items appear prospectively associated with falls. Patients with lower QI codes are more likely to fall. Combining QI items (such as expression and toileting) may improve fall-risk assessment, but some QI items may be too interrelated to use together.

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与住院康复设施中跌倒相关的质量指标展望。

目的：回顾性研究表明，质量指标（QI）与住院康复设施（IRF）中的跌倒有关，但这一说法尚未得到前瞻性验证。本研究旨在分析前瞻性样本中质量指标代码与跌倒之间的关联：在这项前瞻性观察队列研究中，我们对 4 家综合康复中心的 658 名患者进行了为期 6 个月的连续入院和出院随访。入院时，我们收集了患者的 QI 代码，然后追踪他们在 IRF 住院期间是否跌倒：单变量逻辑回归结果显示，大多数关于沟通、自我护理和行动能力的单个 QI 项目与跌倒有显著相关性。在包含 6 个不同 QI 项目的多变量模型中，只有患者上下一个台阶的表现与跌倒有显著相关性。为了解释这一发现，我们研究了这些 QI 项目之间的关系，发现其中 3 个项目高度相关：结论：大多数单个 QI 项目似乎都与跌倒有关。QI 代码较低的患者更容易跌倒。将 QI 项目（如表情和如厕）结合起来可能会改善跌倒风险评估，但有些 QI 项目可能相互关联性太强，不能同时使用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American Journal of Physical Medicine & Rehabilitation 医学-康复医学

CiteScore

4.60

自引率

6.70%

发文量

423

审稿时长

1 months

期刊介绍： American Journal of Physical Medicine & Rehabilitation focuses on the practice, research and educational aspects of physical medicine and rehabilitation. Monthly issues keep physiatrists up-to-date on the optimal functional restoration of patients with disabilities, physical treatment of neuromuscular impairments, the development of new rehabilitative technologies, and the use of electrodiagnostic studies. The Journal publishes cutting-edge basic and clinical research, clinical case reports and in-depth topical reviews of interest to rehabilitation professionals. Topics include prevention, diagnosis, treatment, and rehabilitation of musculoskeletal conditions, brain injury, spinal cord injury, cardiopulmonary disease, trauma, acute and chronic pain, amputation, prosthetics and orthotics, mobility, gait, and pediatrics as well as areas related to education and administration. Other important areas of interest include cancer rehabilitation, aging, and exercise. The Journal has recently published a series of articles on the topic of outcomes research. This well-established journal is the official scholarly publication of the Association of Academic Physiatrists (AAP).