Influence of Medical Comorbidities and Complications on FIM Change and Length of Stay During Inpatient Rehabilitation

Objective: This study was performed to evaluate the influence of medical problems on functional outcome measures of patients admitted for comprehensive inpatient rehabilitation.

Design: In this retrospective database review of patients, demographic information, length of stay, FIM scores at admission and discharge, and FIM efficiency were collected and analyzed. Preexisting comorbidities and acute medical complications of all patients were identified, tabulated, and analyzed.

Results: A total of 175 patients were categorized into three major groups. In the postorthopedic surgery group, the presence of preexisting medical comorbidities did not significantly affect admission or discharge FIM scores. In contrast, traumatic brain injury patients with preexisting medical comorbidities had a tendency to be admitted and discharged with lower FIM scores. However, traumatic brain injury patients with acute medical complications still made reasonable functional improvement during their extended stay, so that their FIM efficiency was adequately maintained. In the cerebrovascular accident group, almost all patients had preexisting medical issues.

Conclusions: The rehabilitation population is diverse, and functional outcome measures for distinct disease entities may be differentially affected by factors such as preexisting medical comorbidities and acute medical complications. Except for life-threatening medical emergencies, rehabilitation patients may benefit by staying on the acute rehabilitation unit, where both medical management and a comprehensive rehabilitation program are provided with continuity.