Citation

Robinson LR, Tam AKH, MacDonald SL, Hanada EY, Berbrayer D, Abdullahi A, Camilotti BG, Tien H. Am. J. Phys. Med. Rehabil. 2019; 98(1): 20-25.

Affiliation

Division of Physical Medicine and Rehabilitation, Sunnybrook Health Sciences Centre and University of Toronto Division of Physical Medicine & Rehabilitation, Department of Medicine, University of Toronto Division of Physical Medicine & Rehabilitation, Faculty of Medicine, University of Toronto St.John's Rehabilitation Hospital - Sunnybrook Health Sciences Centre and University of Toronto Division of Physical Medicine & Rehabilitation University of Toronto, Sunnybrook Health Sciences Centre Institute of Medical Science University of Toronto, Sunnybrook Hospital Department of Physical Medicine and Rehabilitation, Sunnybrook Health Sciences Centre, University of Toronto. Department of Surgery, Sunnybrook Health Sciences Centre and University of Toronto.

Copyright

(Copyright © 2019, Lippincott Williams and Wilkins)

DOI

10.1097/PHM.0000000000001007

PMID

30063526

Abstract

OBJECTIVE: Prior retrospective studies suggest that early physical medicine and rehabilitation (PM&R) consultation for trauma patients improves outcome and reduces acute care length of stay (LOS). There have not been controlled studies to evaluate this impact. This study assesses the impact of PM&R consultations on acute trauma patients.

DESIGN: This study compared measured outcomes before and after the introduction of a PM&R consultation service to the trauma program at a large academic hospital. The primary outcome measure was acute care LOS.

RESULTS: The 274 historical controls and 76 patients who received a PM&R consultation were not different in injury severity score (ISS), age, or gender. LOS was not different between the two groups. However, when early (<8 days post injury) vs. late (>8 days) consults were compared, the early group had a markedly lower LOS (12 vs. 30 days, p<0.001). When adjusted for ISS an early consult was associated with an 11.8 day lower LOS (p<0.001). The early consult group also had fewer complications and less usage of benzodiazepines and antipsychotics.

CONCLUSIONS: An acute care PM&R consultation <8 days after admission is associated with a shorter acute care LOS, fewer complications and less use of benzodiazepines and antipsychotics.

Language: en