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  1. Article ; Online: Association Between COVID-19 and Delirium Development in the General Medical Units at an Academic Medical Center.

    Dong, Yilu / Hanson, Ryan / Penlesky, Annie C / Nattinger, Ann B / Heinrich, Thomas W / Pezzin, Liliana E

    WMJ : official publication of the State Medical Society of Wisconsin

    2024  Volume 122, Issue 5, Page(s) 319–324

    Abstract: Introduction: Evidence suggests that inpatients who develop delirium experience worse outcomes. Although there is reason to believe that COVID-positive patients may be at a higher risk for developing delirium, little is known about the association ... ...

    Abstract Introduction: Evidence suggests that inpatients who develop delirium experience worse outcomes. Although there is reason to believe that COVID-positive patients may be at a higher risk for developing delirium, little is known about the association between COVID-19 and delirium among hospitalized patients outside the intensive care unit (ICU). This study aimed to examine (1) the independent association between COVID-19 infection and the development of delirium among all non-ICU patients and (2) the risk factors associated with developing delirium among patients admitted with COVID-19, with a special focus on presenting symptoms.
    Methods: Using electronic health record (EHR) data of adults admitted to any general medical unit at a large academic medical center from July 2020 through February 2021, we used a cross-sectional multivariable logistic regression to estimate the associations, while adjusting for patients' sociodemographic, clinical characteristics, delirium-free length of stay, as well as time fixed effects.
    Results: Multivariable regression estimates applied to 20 509 patients hospitalized during the study period indicate that COVID-19-positive patients had 72% higher relative risk (odds ratio 1.72; 95% CI, 1.31 - 2.26;
    Conclusions: COVID-19 positivity was associated with higher odds of developing delirium among patients during their non-ICU hospitalization. These findings may be helpful in targeting the use of delirium prevention strategies among non-ICU patients.
    MeSH term(s) Adult ; Humans ; COVID-19/epidemiology ; Cross-Sectional Studies ; Inpatients ; Academic Medical Centers ; Delirium/epidemiology
    Language English
    Publishing date 2024-01-02
    Publishing country United States
    Document type Journal Article
    ZDB-ID 441051-8
    ISSN 2379-3961 ; 0043-6542 ; 1098-1861
    ISSN (online) 2379-3961
    ISSN 0043-6542 ; 1098-1861
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  2. Article: Age-Based Heuristics Bias Treatment of Displaced Femoral Neck Fractures in the Elderly.

    Edelstein, Adam I / Tanenbaum, Joseph T / McGinley, Emily L / Dillingham, Timothy R / Pezzin, Liliana E

    Arthroplasty today

    2024  Volume 27, Page(s) 101356

    Abstract: Background: Surgeons performing arthroplasty for femoral neck fractures may rely on mental shortcuts (heuristics) when choosing total hip arthroplasty (THA) vs hemiarthroplasty (HA). We sought to quantify the extent to which age-based heuristics drive ... ...

    Abstract Background: Surgeons performing arthroplasty for femoral neck fractures may rely on mental shortcuts (heuristics) when choosing total hip arthroplasty (THA) vs hemiarthroplasty (HA). We sought to quantify the extent to which age-based heuristics drive decision-making.
    Methods: We identified all Medicare beneficiaries from 2017-2018 with femoral neck fractures who underwent THA or HA. We compared the likelihood of THA vs HA among patients admitted within 4 weeks before vs 4 weeks after their birthday for each age under the hypothesis that these cohorts would be similar except for numerical age. We controlled for race/ethnicity, sex, comorbidities, poverty status, and hospital census region in a multivariable regression that included facility-level cluster effects. We generated predicted/adjusted probabilities for THA vs HA for different age transition points.
    Results: Thirteen thousand three hundred sixty-six elderly patients were included. One thousand eight hundred sixty-five (14%) received THA and 11,501 (86%) received HA. The likelihood of THA decreased from 50.3% among patients almost 67 to 8% among those ≥85 (
    Conclusions: Our data demonstrate that patient age transitions seem to influence the choice of THA vs HA. Further research is needed to develop data-driven surgical decision aids for this population.
    Language English
    Publishing date 2024-03-16
    Publishing country United States
    Document type Journal Article
    ISSN 2352-3441
    ISSN 2352-3441
    DOI 10.1016/j.artd.2024.101356
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  3. Article ; Online: Rehabilitation after brain tumor resection: A national study of postacute care service use through insurance claims data.

    McLarney, Mitra / Fergestrom, Nicole / Zheng, Jasmine / Pezzin, Liliana E

    PM & R : the journal of injury, function, and rehabilitation

    2023  

    Abstract: Objective: To assess postacute rehabilitation service use and length of stay among a national sample of patients with brain tumors after surgery.: Design: A retrospective review was conducted of health care claims data of a national sample of ... ...

    Abstract Objective: To assess postacute rehabilitation service use and length of stay among a national sample of patients with brain tumors after surgery.
    Design: A retrospective review was conducted of health care claims data of a national sample of patients via The Optum Clinformatics DataMart.
    Setting and participants: This study included adult individuals (≥18 years of age) who were diagnosed with a brain tumor between 2015 and 2019 and underwent a craniotomy or craniectomy within 180 days of diagnosis.
    Methods: Descriptive statistics were used to characterize patients by tumor type. Multivariate models assessed factors associated with discharge setting and length of stay.
    Results: Of the 10,275 individuals identified, 69% had malignant tumors. Over two thirds of patients were discharged directly home (with or without home health care) and 9.3% and 9.5% were discharged to acute rehabilitation facilities (inpatient rehabilitation facilities [IRF]) and skilled nursing facilities (SNF/ICF), respectively. About 13.5% were discharged to other settings. The average length of stay during the episode of care was 8.6 (SD = 9.6) days. After adjusting for confounders, individuals with benign brain tumors were more likely to be discharged to either IRF or SNF/ICF than return home after acute care stay, as were those with greater comorbidities, older age, fee-for-service and health maintenance organization insurance. Wealthier patients were less likely to be discharged to a SNF/ICF than home, although income was not a factor affecting discharge to an IRF. Patients with benign tumors, the oldest old (80+), those with more comorbidities as well as Black and Hispanic patients had a longer length of stay during the acute hospitalization.
    Conclusions: Individuals with brain tumors have deficits amenable to rehabilitation; however, this study finds that service use differs by tumor type and demographic and socioeconomic factors. Further study is needed to identify if there are barriers to access and use of rehabilitation services in this population.
    Language English
    Publishing date 2023-12-21
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2608988-9
    ISSN 1934-1563 ; 1934-1482
    ISSN (online) 1934-1563
    ISSN 1934-1482
    DOI 10.1002/pmrj.13117
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  4. Article ; Online: Race, ethnicity, and utilization of outpatient rehabilitation for treatment of post COVID-19 condition.

    Hentschel, Claudia B / Abramoff, Benjamin A / Dillingham, Timothy R / Pezzin, Liliana E

    PM & R : the journal of injury, function, and rehabilitation

    2022  Volume 14, Issue 11, Page(s) 1315–1324

    Abstract: Introduction: Outpatient rehabilitation is recommended in the treatment of post coronavirus disease 2019 (COVID-19) condition. Although racial and ethnic disparities in the incidence and severity of COVID-19 have been well documented, little is known ... ...

    Abstract Introduction: Outpatient rehabilitation is recommended in the treatment of post coronavirus disease 2019 (COVID-19) condition. Although racial and ethnic disparities in the incidence and severity of COVID-19 have been well documented, little is known about the use of outpatient rehabilitation among patients with post COVID-19 condition.
    Objective: To examine factors associated with outpatient rehabilitation use following COVID-19 and to ascertain whether differential incidence of sequelae explain variation in post COVID-19 rehabilitation utilization by race and ethnicity.
    Design: Case-control study.
    Setting: Community.
    Participants: U.S. adults with COVID-19 during 2020 in the TriNetX database.
    Intervention: N/A.
    Main outcome measures: Receipt of outpatient rehabilitation services within 6 months of COVID-19 diagnosis and incidence of post COVID-19 condition symptoms (weakness, fatigue, pain, cognitive impairment, mobility difficulties, and dyspnea).
    Results: From 406,630 laboratory-confirmed COVID-19 cases, we identified 8724 individuals who received outpatient rehabilitation and matched 28,719 controls. Of rehabilitation users, 43.3% were 40 years old or younger, 54.8% were female, 58.2% were White, 17.9% were African American/Black, 2.1% were Asian, 13.0% were Hispanic, 39.2% had no comorbidities, and 40.3% had been hospitalized for COVID-19. Dyspnea (20.4%), fatigue (12.4%), and weakness (8.2%) were the most frequently identified symptoms. Although there were no racial differences in the incidence of the six post COVID-19 condition symptoms considered, African American/Black individuals were significantly less likely than their White counterparts to receive outpatient rehabilitation (odds ratio [OR] = 0.89; 95% confidence interval [CI]: 0.84-0.96; p = .003). Hispanic individuals had higher outpatient rehabilitation utilization (OR = 1.22; 95% CI: 1.11-1.33; p < .001) and a significantly higher incidence of post COVID-19 fatigue.
    Conclusions: In this large nationally representative study, African American/Black race was associated with lower utilization of outpatient rehabilitation services despite a similar incidence of post COVID-19 condition symptoms. Further research is needed to better understand access barriers to rehabilitation services for post COVID-19 condition recovery care and address racial inequalities in receipt of care.
    MeSH term(s) Humans ; Adult ; Female ; United States/epidemiology ; Male ; COVID-19/epidemiology ; Ethnicity ; Outpatients ; Case-Control Studies ; COVID-19 Testing ; Dyspnea ; Fatigue
    Language English
    Publishing date 2022-08-30
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 2608988-9
    ISSN 1934-1563 ; 1934-1482
    ISSN (online) 1934-1563
    ISSN 1934-1482
    DOI 10.1002/pmrj.12869
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  5. Article ; Online: Hemiarthroplasty Versus Total Hip Arthroplasty for Femoral Neck Fracture in Elderly Patients: Twelve-Month Risk of Revision and Dislocation in an Instrumental Variable Analysis of Medicare Data.

    Edelstein, Adam I / Dillingham, Timothy R / McGinley, Emily L / Pezzin, Liliana E

    The Journal of bone and joint surgery. American volume

    2023  Volume 105, Issue 21, Page(s) 1695–1702

    Abstract: Background: There is practice variation in the selection of a total hip arthroplasty (THA) or a hemiarthroplasty (HA) for the treatment of displaced femoral neck fractures in elderly patients. Large data sets are needed to compare the rates of rare ... ...

    Abstract Background: There is practice variation in the selection of a total hip arthroplasty (THA) or a hemiarthroplasty (HA) for the treatment of displaced femoral neck fractures in elderly patients. Large data sets are needed to compare the rates of rare complications following these procedures. We sought to examine the relationship between surgery type and secondary hip surgery (revision or conversion arthroplasty) at 12 months following the index arthroplasty, and that between surgery type and dislocation at 12 months, among elderly Medicare beneficiaries who underwent THA or HA for a femoral neck fracture, taking into account the potential for selection bias.
    Methods: We performed a population-based, retrospective study of elderly (>65 years of age) Medicare beneficiaries who underwent THA or HA following a femoral neck fracture. Two-stage, instrumental variable regression models were applied to nationally representative Medicare medical claims data from 2017 to 2019.
    Results: Of the 61,695 elderly patients who met the inclusion criteria, of whom 74.1% were female and 92.2% were non-Hispanic White, 10,268 patients (16.6%) underwent THA and 51,427 (83.4%) underwent HA. The findings from the multivariable, instrumental variable analyses indicated that treatment of displaced femoral neck fractures with THA was associated with a significantly higher risk of dislocation at 12 months compared with treatment with HA (2.9% for the THA group versus 1.9% for the HA group; p = 0.001). There was no significant difference in the likelihood of 12-month revision/conversion between THA and HA.
    Conclusions: The use of THA to treat femoral neck fractures in elderly patients is associated with a significantly higher risk of 12-month dislocation, as compared with the use of HA, although the difference may not be clinically important. A low overall rate of dislocation was found in both groups. The risk of revision/conversion at 12 months did not differ between the groups.
    Level of evidence: Therapeutic Level III . See Instructions for Authors for a complete description of levels of evidence.
    MeSH term(s) Humans ; Female ; Aged ; United States/epidemiology ; Male ; Arthroplasty, Replacement, Hip/adverse effects ; Retrospective Studies ; Hemiarthroplasty/adverse effects ; Hemiarthroplasty/methods ; Medicare ; Joint Dislocations/surgery ; Femoral Neck Fractures/surgery ; Reoperation
    Language English
    Publishing date 2023-09-06
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 220625-0
    ISSN 1535-1386 ; 0021-9355
    ISSN (online) 1535-1386
    ISSN 0021-9355
    DOI 10.2106/JBJS.23.00247
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  6. Article ; Online: The Impact of Femoral Component Cementation on Fracture and Mortality Risk in Elective Total Hip Arthroplasty: Analysis from a National Medicare Sample.

    Edelstein, Adam I / Hume, Eric L / Pezzin, Liliana E / McGinley, Emily L / Dillingham, Timothy R

    The Journal of bone and joint surgery. American volume

    2022  Volume 104, Issue 6, Page(s) 523–529

    Abstract: Background: Complications following elective total hip arthroplasty (THA) are rare but potentially devastating. The impact of femoral component cementation on the risk of periprosthetic femoral fractures and early perioperative death has not been ... ...

    Abstract Background: Complications following elective total hip arthroplasty (THA) are rare but potentially devastating. The impact of femoral component cementation on the risk of periprosthetic femoral fractures and early perioperative death has not been studied in a nationally representative population in the United States.
    Methods: Elective primary THAs performed with or without cement among elderly patients were identified from Medicare claims from 2017 to 2018. We performed separate nested case-control analyses matched 1:2 on age, sex, race/ethnicity, comorbidities, payment model, census division of facility, and exposure time and compared fixation mode between (1) groups with and without 90-day periprosthetic femoral fracture and (2) groups with and without 30-day mortality.
    Results: A total of 118,675 THAs were included. The 90-day periprosthetic femoral fracture rate was 2.0%, and the 30-day mortality rate was 0.18%. Cases were successfully matched. The risk of periprosthetic femoral fracture was significantly lower among female patients with cement fixation compared with matched controls with cementless fixation (OR = 0.83; 95% CI, 0.69 to 1.00; p = 0.05); this finding was not evident among male patients (p = 0.94). In contrast, the 30-day mortality risk was higher among male patients with cement fixation compared with matched controls with cementless fixation (OR = 2.09; 95% CI, 1.12 to 3.87; p = 0.02). The association between cement usage and mortality among female patients almost reached significance (OR = 1.74; 95% CI, 0.98 to 3.11; p = 0.06).
    Conclusions: In elderly patients managed with THA, cemented stems were associated with lower rates of periprosthetic femoral fracture among female patients but not male patients. The association between cemented stems and higher rates of 30-day mortality was significant for male patients and almost reached significance for female patients, although the absolute rates of mortality were very low. For surgeons who can competently perform THA with cement, our data support the use of a cemented stem to avoid periprosthetic femoral fracture in elderly female patients.
    Level of evidence: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
    MeSH term(s) Aged ; Arthroplasty, Replacement, Hip/adverse effects ; Bone Cements/adverse effects ; Cementation ; Female ; Femoral Fractures/chemically induced ; Femoral Fractures/surgery ; Hip Prosthesis/adverse effects ; Humans ; Male ; Medicare ; Periprosthetic Fractures/etiology ; Reoperation/adverse effects ; Retrospective Studies ; Risk Factors ; United States/epidemiology
    Chemical Substances Bone Cements
    Language English
    Publishing date 2022-01-04
    Publishing country United States
    Document type Journal Article
    ZDB-ID 220625-0
    ISSN 1535-1386 ; 0021-9355
    ISSN (online) 1535-1386
    ISSN 0021-9355
    DOI 10.2106/JBJS.21.00640
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  7. Article ; Online: Prevalence of Race/Ethnicity Reporting in Light Chain (AL) Amyloidosis Clinical Research in the USA.

    Lin, Mingqian / Pezzin, Liliana E / Mohamedi, Ali / Kansagra, Ankit / D'Souza, Anita

    Journal of racial and ethnic health disparities

    2022  Volume 10, Issue 2, Page(s) 644–650

    Abstract: Little is known about racial differences in the incidence of light chain (AL) amyloidosis despite the well-documented racial disparities in the epidemiology of other plasma cell disorders. The goal of this study was to examine the extent to which ... ...

    Abstract Little is known about racial differences in the incidence of light chain (AL) amyloidosis despite the well-documented racial disparities in the epidemiology of other plasma cell disorders. The goal of this study was to examine the extent to which published clinical research in AL amyloidosis report information on patients' race. Clinical research publications in AL amyloidosis between January 1, 2010, and December 31, 2020, from the USA were identified. In addition to the reporting of race, study design, funding, cohort size, year of publication, impact factor of publication journal, and first author degree were abstracted. Among papers reporting race, we also assessed whether ethnicity was reported separately. A PubMed search yielded 2,770 papers of which 220 met the pre-specified criteria for analysis. Of those, 37 (16.5%) reported race. Single institution publications, those with physicians as first authors, and those published in journals with impact factor 6 or higher were less likely to report race. On multivariate analysis, only single institution studies were negatively associated with race reporting. Of the 37 papers reporting race, none defined it in methods, 16% stated how race was identified, and 19% discussed its significance. Ethnicity was reported in 6 studies. Our results indicate that race/ethnicity is underreported in USA. AL amyloidosis clinical literature leads to a challenge for identifying potential racial/ethnic disparities. Standards for collecting and reporting racial/ethnic demographics are needed. Clear and consistent reporting of race and ethnicity of clinical populations is a necessary first step in identifying disparities and promoting equitable care.
    MeSH term(s) Humans ; United States/epidemiology ; Ethnicity ; Prevalence ; Immunoglobulin Light-chain Amyloidosis ; Racial Groups ; Research Design
    Language English
    Publishing date 2022-02-01
    Publishing country Switzerland
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, N.I.H., Extramural
    ZDB-ID 2760524-3
    ISSN 2196-8837 ; 2197-3792
    ISSN (online) 2196-8837
    ISSN 2197-3792
    DOI 10.1007/s40615-022-01252-3
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  8. Article ; Online: Centralization of Initial Care and Improved Survival of Poor Patients With Breast Cancer.

    Nattinger, Ann B / Bickell, Nina A / Schymura, Maria J / Laud, Purushottam / McGinley, Emily L / Fergestrom, Nicole / Pezzin, Liliana E

    Journal of clinical oncology : official journal of the American Society of Clinical Oncology

    2023  Volume 41, Issue 11, Page(s) 2067–2075

    Abstract: Purpose: Poor women with breast cancer have worse survival than others, and are more likely to undergo surgery in low-volume facilities. We leveraged a natural experiment to study the effectiveness of a policy intervention undertaken by New York (NY) ... ...

    Abstract Purpose: Poor women with breast cancer have worse survival than others, and are more likely to undergo surgery in low-volume facilities. We leveraged a natural experiment to study the effectiveness of a policy intervention undertaken by New York (NY) state in 2009 that precluded payment for breast cancer surgery for NY Medicaid beneficiaries treated in facilities performing fewer than 30 breast cancer surgeries annually.
    Methods: We identified 37,822 women with stage I-III breast cancer during 2004-2008 or 2010-2013 and linked them to NY hospital discharge data. A multivariable difference-in-differences approach compared mortality of Medicaid insured patients with that of commercially or otherwise insured patients unaffected by the policy.
    Results: Women treated during the postpolicy years had slightly lower 5-year overall mortality than those treated prepolicy; the survival gain was significantly larger for Medicaid patients (
    Conclusion: A statewide centralization policy discouraging initial care for breast cancer in low-volume facilities was associated with better survival for the Medicaid population targeted. Given these impressive results and those from prior research, other policymakers should consider adopting comparable policies to improve breast cancer outcomes.[Media: see text].
    MeSH term(s) United States ; Humans ; Female ; Breast Neoplasms ; Medicaid ; New York
    Language English
    Publishing date 2023-01-05
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 604914-x
    ISSN 1527-7755 ; 0732-183X
    ISSN (online) 1527-7755
    ISSN 0732-183X
    DOI 10.1200/JCO.22.02012
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  9. Article ; Online: The Association of multiple sclerosis, traumatic brain injury, and spinal cord injury to acute and long COVID-19 outcomes.

    Abramoff, Benjamin A / Hentschel, Claudia / Dillingham, Ingram A / Dillingham, Timothy / Baraniecki-Zwil, Gwen / Williams, Asha / Pezzin, Liliana E

    PM & R : the journal of injury, function, and rehabilitation

    2023  

    Abstract: Background: Although persons with disabilities are a high-risk group, little is known about the association between specific disabling conditions and acute or long COVID outcomes.: Objective: To examine the severity of acute SARS-CoV-2 infection and ... ...

    Abstract Background: Although persons with disabilities are a high-risk group, little is known about the association between specific disabling conditions and acute or long COVID outcomes.
    Objective: To examine the severity of acute SARS-CoV-2 infection and post-COVID outcomes among people with a preexisting diagnosis of multiple sclerosis (MS), spinal cord injury (SCI), or traumatic brain injury (TBI).
    Methods: This was a retrospective cohort study using the TrinetX Research Database, a large representative database of medical records. COVID-19-positive persons with MS, SCI, or TBI (cases) were matched 1:1 on age, gender, race, ethnicity, and comorbidities to COVID-19-positive persons without these diagnoses (controls). The main outcomes assessed were hospitalization for acute COVID-19, length of stay (LOS), the total number of hospitalizations, mortality, and incidence of six prevalent post-COVID sequelae within 6 months following a COVID-19 diagnosis.
    Results: There were 388,297 laboratory-confirmed COVID-19 cases identified. Of these cases, 2204 individuals had one of the following preexisting diagnoses: 51.3% TBI, 31.4% MS, and 17.3% SCI. People with TBI, MS, and SCI were significantly more likely to be hospitalized for COVID-19 (odds ratio [OR] = 1.22, 95% confidence interval [CI] = 1.03-1.46) than matched controls. There was no difference in LOS, total hospitalizations, or mortality during the 6 months following the initial COVID diagnosis. Multivariable analyses reveal that persons with TBI, MS, and SCI were more likely to experience new weakness (OR = 1.54, 95% CI = 1.19-2.00), mobility difficulties (OR = 1.66, 95% CI = 1.17-2.35), and cognitive dysfunction (OR = 1.79, 95% CI = 1.38-2.33) than controls, even after controlling for the presence of these symptoms prior to their COVID infection and other risk factors. There were no differences in fatigue, pain, or dyspnea.
    Conclusions: Having a history of MS, SCI or TBI was not associated with higher mortality risk from COVID-19. However, associations between these diagnoses and postacute COVID-19 symptoms raise concern about widening health outcome disparities for individuals with such potentially disabling conditions following COVID-19 infection.
    Language English
    Publishing date 2023-12-25
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2608988-9
    ISSN 1934-1563 ; 1934-1482
    ISSN (online) 1934-1563
    ISSN 1934-1482
    DOI 10.1002/pmrj.13121
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  10. Article ; Online: Inpatient Rehabilitation Outcomes After Severe COVID-19 Infections: A Retrospective Cohort Study.

    Abramoff, Benjamin A / Dillingham, Timothy R / Caldera, Franklin E / Ritchie, Marylyn D / Pezzin, Liliana E

    American journal of physical medicine & rehabilitation

    2021  Volume 100, Issue 12, Page(s) 1109–1114

    Abstract: Objective: The aim of the study was to describe the characteristics and functional outcomes of patients undergoing acute inpatient rehabilitation after hospitalization for COVID-19.: Design: Using a retrospective chart review, patients were ... ...

    Abstract Objective: The aim of the study was to describe the characteristics and functional outcomes of patients undergoing acute inpatient rehabilitation after hospitalization for COVID-19.
    Design: Using a retrospective chart review, patients were identified who were admitted to inpatient rehabilitation after COVID-19. Patient information collected included sociodemographic characteristics, comorbidities, length of stay, discharge disposition, self-care, mobility, and cognitive functioning. These patients were compared with patients (controls) without COVID-19 with similar impairment codes treated at the same facility before the COVID-19 pandemic.
    Results: There were 43 patients who were admitted to the inpatient rehabilitation hospital after COVID-19 infection and 247 controls. Patients who had COVID-19 were significantly more likely to be African American and to have been admitted to a long-term acute care hospital. They also had a longer length of rehabilitation stay. The groups did not differ by age, sex, or insurance. Functionally, although presenting with significantly worse mobility, self-care, and motor scores, the patients previously infected with COVID-19 had similar functional outcomes at time of discharge to the control group.
    Conclusions: Although patients with a history of COVID-19 had worse function at time of admission to acute rehabilitation, inpatient rehabilitation significantly improved their function to comparable levels as patients who did not have COVID-19.
    To claim cme credits: Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME.
    Cme objectives: Upon completion of this article, the reader should be able to: (1) Identify how characteristics of patients with COVID-19 admitted to acute rehabilitation differ from those with similar admission codes but without COVID-19; (2) Describe changes in functional measures at admission and discharge of COVID-19 patients compared with patients without COVID-19; and (3) Recognize how inpatient rehabilitation may help reduce inequities in outcomes after severe COVID-19 infection.
    Level: Advanced.
    Accreditation: The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.The Association of Academic Physiatrists designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
    MeSH term(s) Aged ; COVID-19/rehabilitation ; Case-Control Studies ; Disability Evaluation ; Female ; Functional Status ; Hospitalization ; Hospitals, Rehabilitation/statistics & numerical data ; Humans ; Length of Stay/statistics & numerical data ; Male ; Middle Aged ; Patient Discharge/statistics & numerical data ; Recovery of Function ; Retrospective Studies ; SARS-CoV-2 ; Time Factors ; Treatment Outcome
    Language English
    Publishing date 2021-10-22
    Publishing country United States
    Document type Journal Article
    ZDB-ID 219390-5
    ISSN 1537-7385 ; 0002-9491 ; 0894-9115
    ISSN (online) 1537-7385
    ISSN 0002-9491 ; 0894-9115
    DOI 10.1097/PHM.0000000000001885
    Database MEDical Literature Analysis and Retrieval System OnLINE

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