OBJECTIVES: To test whether functional status is a robust predictor of acute care readmission risk in patients who have been discharged to an inpatient rehabilitation facility (IRF) following a unilateral hip fracture. STUDY DESIGN: Retrospective database study using a large administrative data set. METHODS: A retrospective analysis of data from the Uniform Data System for Medical Rehabilitation from the years 2002 to 2011 was performed, examining patients with an impairment of unilateral hip fracture. A basic prediction model based on functional status was compared with competing models incorporating medical comorbidities. C statistics were compared to evaluate model performance. RESULTS: There were a total of 433,154 patients: 32,783 (7.87%) patients were transferred back to an acute hospital, including 7937 (1.91%) transferred within 3 days, 16,150 (3.88%) transferred within 7 days, and 32,607 (7.83%) transferred within 30 days after IRF admission. The C statistics for the Basic Model are 0.710, 0.674, and 0.667 at days 3, 7, and 30, respectively. Compared with the Basic Model, the best performing Basic-Plus model was the Basic+Elixhauser Model with C statistic differences of +0.013, +0.014, and +0.019, and the best performing Age-Comorbidity Model was the Age+Elixhauser Model with C statistic differences of -0.110, -0.079, and -0.065 at days 3, 7, and 30, respectively. CONCLUSIONS: Functional status is a robust and potentially modifiable risk factor for patients admitted to IRFs following a unilateral hip fracture.
OBJECTIVES: To test whether functional status is a robust predictor of acute care readmission risk in patients who have been discharged to an inpatient rehabilitation facility (IRF) following a unilateral hip fracture. STUDY DESIGN: Retrospective database study using a large administrative data set. METHODS: A retrospective analysis of data from the Uniform Data System for Medical Rehabilitation from the years 2002 to 2011 was performed, examining patients with an impairment of unilateral hip fracture. A basic prediction model based on functional status was compared with competing models incorporating medical comorbidities. C statistics were compared to evaluate model performance. RESULTS: There were a total of 433,154 patients: 32,783 (7.87%) patients were transferred back to an acute hospital, including 7937 (1.91%) transferred within 3 days, 16,150 (3.88%) transferred within 7 days, and 32,607 (7.83%) transferred within 30 days after IRF admission. The C statistics for the Basic Model are 0.710, 0.674, and 0.667 at days 3, 7, and 30, respectively. Compared with the Basic Model, the best performing Basic-Plus model was the Basic+Elixhauser Model with C statistic differences of +0.013, +0.014, and +0.019, and the best performing Age-Comorbidity Model was the Age+Elixhauser Model with C statistic differences of -0.110, -0.079, and -0.065 at days 3, 7, and 30, respectively. CONCLUSIONS: Functional status is a robust and potentially modifiable risk factor for patients admitted to IRFs following a unilateral hip fracture.
Authors: Donna Huang; Chloe Slocum; Julie K Silver; James W Morgan; Richard Goldstein; Ross Zafonte; Jeffrey C Schneider Journal: J Spinal Cord Med Date: 2018-03-29 Impact factor: 1.985
Authors: Chloe Slocum; Paul Gerrard; Randie Black-Schaffer; Richard Goldstein; Aneesh Singhal; Margaret A DiVita; Colleen M Ryan; Jacqueline Mix; Maulik Purohit; Paulette Niewczyk; Lewis Kazis; Ross Zafonte; Jeffrey C Schneider Journal: PLoS One Date: 2015-11-23 Impact factor: 3.240