scholarly journals Epidemiology of Nosocomial Infection and Resistant Organisms in Patients Admitted for the First Time to an Acute Rehabilitation Unit

2000 ◽  
Vol 30 (3) ◽  
pp. 425-432 ◽  
Author(s):  
J. M. Mylotte ◽  
R. Graham ◽  
L. Kahler ◽  
L. Young ◽  
S. Goodnough
Keyword(s):  
Nosocomial Infection ◽  
Rehabilitation Unit ◽  
Acute Rehabilitation ◽  
First Time

Impact of Nosocomial Infection on Length of Stay and Functional Improvement Among Patients Admitted to an Acute Rehabilitation Unit

2001 ◽  
Vol 22 (02) ◽  
pp. 83-87 ◽  
Author(s):  
Joseph M. Mylotte ◽  
Robin Graham ◽  
Lucinda Kahler ◽  
B. Lauren Young ◽  
Susan Goodnough
Keyword(s):  
Length Of Stay ◽  
Nosocomial Infection ◽  
Functional Status ◽  
Functional Independence ◽  
Functional Improvement ◽  
Multivariate Linear Regression Analysis ◽  
Rehabilitation Unit ◽  
Cord Injury ◽  
Acute Rehabilitation ◽  
First Time

AbstractObjective:To identify factors predictive of length of stay (LOS) and the level of functional improvement achieved among patients admitted to an acute rehabilitation unit for the first time, with special reference to the role of nosocomial infection.Setting:A 40-bed acute rehabilitation unit within a 300-bed, tertiary-care, public, university-affiliated hospital.Study Population:All patients admitted to the unit between January 1997 and July 1998.Design:Prospective cohort study in which demographic and clinical data, including occurrence of nosocomial infection, were collected during the entire unit admission of each patient. Multivariate linear regression analysis was used to identify factors predictive of unit LOS or improvement in functional status as measured by the change in the Functional Independence Measure (FIM) score between admission and discharge (ΔFIM).Results:There were 423 admissions to the rehabilitation unit during the study period, of which 91 (21.5%) had spinal cord injury (SCI) as a principal diagnosis. One hundred seven nosocomial infections occurred during 84 (19.9%) of the 423 admissions. The most common infections were urinary tract (31.8% of all infections), surgical-site (18.5%), andClostridium difficilediarrhea (15%). Only one patient died of infection. After controlling for severity of illness on admission, functional status on admission, age, and other clinical factors, the significant positive predictors of unit LOS were as follows: SCI (P<.001), pressure ulcer (.002), and nosocomial infection (<.001). Significant negative predictors of ΔFIM were age (P<.001), FIM score on admission (<.001), prior hospital LOS (.002), and nosocomial infection (.007).Conclusions:Several variables were identified as contributing to a longer LOS or to a smaller improvement in functional status among patients admitted for the first time to an acute rehabilitation unit Of these variables, only nosocomial infection has the potential for modification. Studies of new approaches to prevent infections among patients undergoing acute rehabilitation should be pursued.

Severe Disability After Stroke: Outcome After Inpatient Rehabilitation

1999 ◽  
Vol 13 (3) ◽  
pp. 199-203 ◽  
Author(s):  
John G. Schmidt ◽  
Jessie Drew-Cates ◽  
Mary L. Dombovy
Keyword(s):  
Functional Outcome ◽  
Hemorrhagic Stroke ◽  
Inpatient Rehabilitation ◽  
Functional Independence ◽  
Efficiency Score ◽  
Poor Functional Outcome ◽  
Rehabilitation Unit ◽  
Home Setting ◽  
Severe Stroke ◽  
Acute Rehabilitation

Objective: To determine the functional outcome following acute rehabilitation of patients with severe and very severe stroke using the Functional Independence Mea sure (FIM). Background: Most patients with severe and very severe stroke are reported in the literature to have a poor functional outcome. However, there are few studies that specifically address severity and their conclusions are confounding. Methods: We retrospectively reviewed charts of 41 consecutive patients with the primary diag nosis of ischemic or hemorrhagic stroke admitted to an inpatient rehabilitation unit with a admission FIM score of <60. Outcome measures included discharge residence, length of stay, and FIM score. Results: Over 63 percent (26 patients) were discharged to home. Discharge mean FIM scores (61.24) were significantly improved over the admission mean FIM (34.12) for self-care, mobility, communication, and social cog nition. The FIM Efficiency score was 0.356/day (mean[FIMdis-FIMadm]/mean LOS) as compared with previous reports of FIM Efficiency of 0.97/day for all stroke. Con clusion: Patients with severe stroke can experience improvement during inpatient rehabilitation and be discharged to a home setting, although the rate of improvement is less than that of more moderate stroke.

Evaluation and treatment of psychological disturbance on an acute rehabilitation unit

2013 ◽  
Author(s):  
Tenisha Hancock ◽  
Martin Stern ◽  
Jena Kravitz ◽  
Jeffrey Wertheimer
Keyword(s):  
Psychological Disturbance ◽  
Rehabilitation Unit ◽  
Acute Rehabilitation

Cognitively Impaired Stroke Patients Do Benefit From Admission to an Acute Rehabilitation Unit

2008 ◽  
Vol 89 (3) ◽  
pp. 441-448 ◽  
Author(s):  
Meheroz H. Rabadi ◽  
Freny M. Rabadi ◽  
Lisa Edelstein ◽  
Margaret Peterson
Keyword(s):  
Cognitively Impaired ◽  
Stroke Patients ◽  
Rehabilitation Unit ◽  
Acute Rehabilitation

Stroke mimic in an acute rehabilitation unit patient with associated hypomagnesaemia

2021 ◽  
Vol 14 (4) ◽  
pp. e239777
Author(s):  
Mia X Shan ◽  
Andrew Hanna ◽  
Emmanuel G Villalpando ◽  
Dixie Aragaki
Keyword(s):  
Emergency Department ◽  
Comprehensive Evaluation ◽  
Rehabilitation Unit ◽  
Stroke Mimics ◽  
Laboratory Results ◽  
Acute Infarct ◽  
Facial Numbness ◽  
Stroke Mimic ◽  
Acute Rehabilitation ◽  
Work Up

This case report describes a patient who presented with acute left facial numbness and eyelid weakness prompting work-up, which demonstrated low suspicion for new stroke but revealed hypomagnesaemia as a potential differential diagnosis. Patient initially presented to the emergency department with left upper extremity weakness and was diagnosed with right basal ganglia infarction. Two weeks after transfer to the acute rehabilitation unit, patient suddenly complained of left facial numbness and eyelid weakness. However, brain imaging did not show any new acute infarct. Instead, laboratory results showed hypomagnesaemia at 1.50 mg/dL. Patient was therefore treated with intravenous magnesium leading to resolution of his symptoms. Up to 30% of acute stroke presentations are stroke mimics. Although hypomagnesaemia is less frequently seen as a mimic, its neuromuscular manifestations may present with similar symptoms. Patients will always benefit from a comprehensive evaluation for stroke symptoms, but it is important to consider the mimics as well.

Abstract WP238: Thrombolytic Use in Stroke Mimics via Telestroke

Stroke ◽  
2016 ◽  
Vol 47 (suppl_1) ◽  
Author(s):  
Ganesh Asaithambi ◽  
Amy L Castle ◽  
Michael A Sperl ◽  
Aditi Gupta ◽  
Jayashree Ravichandran ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Intravenous Thrombolysis ◽  
Stroke Patients ◽  
Rehabilitation Unit ◽  
Stroke Mimics ◽  
Symptomatic Intracerebral Hemorrhage ◽  
Stroke Mimic ◽  
Comprehensive Stroke Center ◽  
Stroke Center ◽  
Acute Rehabilitation

Background: It has been established that safety and outcomes of intravenous thrombolysis (IVT) to stroke patients via telestroke (TS) is similar to those presenting to stroke centers. Little is known on the accuracy of TS diagnosis among those receiving IVT. We sought to compare the rate of stroke mimic (SM) patients receiving IVT in our TS network to those who present to our comprehensive stroke center (CSC). Methods: Consecutive patients receiving IVT between August 2014 and June 2015 were identified at our CSC and TS network. The rates of SM patients in each cohort were calculated. Outcomes measured included rates of symptomatic intracerebral hemorrhage (sICH), in-hospital mortality, and discharge to home or an acute rehabilitation unit (ARU). Results: During the study period, 132 patients (mean age 71±15 years, 49% women) receiving IVT were included in the analysis (75 CSC, 57 TS). Rates of SM patients receiving IVT were similar (CSC 12% vs TS 7%, p=0.39). One stroke patient developed sICH, and three other stroke patients experienced in-hospital mortality; neither outcome was found in the SM cohort. Discharge to home or ARU was similar between stroke (76.5%) and SM (76.9%) patients (p=1). Patients with SMs had significantly higher diagnoses of migraine (p=0.045) and psychiatric disorders (p=0.0002) compared to stroke patients. Conclusion: The rate of IVT among SM patients via TS is low and similar to those who present directly to a stroke center. Continued efforts should be made to further minimize IVT in SM patients despite the low rate of complications.

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