INPATIENT REHABILITATION OUTCOMES IN HAEMODIALYSIS PATIENTS: AN ANALYSIS INTO MISSED THERAPY
Dr Abdul Mueez Khalil1, Dr HUI-SHAN LIN1, Dr KIRSTEN HEPBURN2,3
1Geriatrics and Rehabilitation Unit, Surgical Treatment and Rehabilitation Service, Herston, Australia, 2Kidney Health Service, Metro North Hospital and Health Service, Herston, Australia, 3Faculty of Medicine, University of Queensland, Herston, Australia
Aim: To compare the percentage of missed therapies during inpatient rehabilitation between haemodialysis (HD) and non-haemodialysis patients, and to examine its relationship with length of stay (LOS) and functional independence measure (FIM).
Background: HD patients are at higher risk of co-morbidities and deconditioning, necessitating inpatient rehabilitation to return to premorbid function and mobility. HD patients are known to have worse rehabilitation outcomes, however the reasons for this have not been explored previously.
Methods: Retrospective cohort study of HD and non-HD patients admitted to an inpatient rehabilitation service between 1st January 2023 and 30th December 2023. Demographics, total therapies prescribed and missed, LOS and admission/discharge FIM were extracted from clinical records. Results were summarised descriptively, and group differences were examined using Pearson’s chi-square or Fisher’s exact test and Mann-Whitney U test. Spearman’s coefficient was used to measure correlation.
Results: Twenty-six HD patient admissions were matched 1:1 to non-HD patients on age, Australasian Rehabilitation Outcomes Centre (AROC) code and gender. Overall mean age was 67.7 (SD 11.1); 65.4% were males, mainly admitted for deconditioning (53.8%). HD patients were offered more therapies compared to non-HD (median 24 vs 17) however the percentage of therapy completion was lower for HD patients (88.5% (IQR 75.8-100) vs 94.0% (86.7-100), p=0.17). HD patients missed more therapies per person than non-HD patients (5 (SD 3.3) vs 4 (SD 3.5), p=0.39). The percentage of missed therapy was moderately correlated with lower FIM change (-0.53) but weak correlation with LOS (0.18).
Conclusion: HD patients are less likely to complete prescribed allied health therapy during inpatient rehabilitation, which is likely linked to lower FIM change. Further studies with larger cohorts are needed to confirm this correlation.
Biography:
Dr Abdul Mueez Khalil is a Senior House Officer at the Royal Brisbane and Women’s Hospital. He is currently on the Basic Physician Training pathway in hopes of pursuing a career in nephrology.