• Analysis of Sling Wear Time after Shoulder Surgery

      Gilotra, Mohit N; Terrin, Michael L. (2021)
      Introduction: Sling wear is a component of rehabilitation after shoulder surgery. The purposes of this study were to observe the predictors of sling wear and to determine if a threshold of sling compliance improved patient-reported outcomes. Methods: We performed a prospective observational study of 105 postoperative patients fitted with temperature-sensing slings to monitor adherence. Demographic factors were analyzed as predictors of sling wear. The relationship of actual sling wear with patient reported and radiographic outcome was explored. Results: There was a weak correlation between patient reported and actual sling wear time. Females and patients with lower BMI were most likely to be 80% adherent with sling wear and exhibited better patient reported outcomes but no difference in radiographic failures. Conclusion: There is an association between high adherence and patient reported outcome. Further studies will elicit the social mediators of postoperative sling behavior and treatments to improve patient adherence and outcome.
    • Factors Associated with Length of Stay and Discharge Disposition in Older Trauma Patients

      Brotemarkle, Rebecca Ann; Resnick, Barbara (2013)
      Factors Associated with Length of Stay and Discharge Disposition in Older Trauma Patients Abstract Background: Trauma patients over the age of 65 are living longer and staying active at older ages. Older trauma patients tend to have longer lengths of stay (LOS) and to be discharged more often to rehabilitation and skilled nursing facilities. Understanding the factors that influence LOS and discharge disposition is needed to guide interventions focused on decreasing LOS and assuring that patients are discharged to the least restrictive setting. Purpose: The purpose of this study was to explore the impact of patient and system related factors on LOS and discharge disposition for older adults hospitalized for traumatic injury. Methods: This was a secondary data analysis using descriptive data from rehabilitation notes during inpatient encounters. Data analysis was done using structural equation modeling and logistic regression. Results: 132 patients were randomly selected from 1387 patients admitted to a level 1 trauma center. The majority were Caucasian (83.9%, n = 111), 46.9% (n = 62) were males with an average age of 78.3 (S.D. = 9.7) years. On average participants had 2.29 (S.D. = 1.96) comorbidities and approximately two thirds (65.9%, n = 87) were rated as having severe injuries. The average length of stay was 4.3 (S.D. = 4.0) days with 57.6% (n = 76) of patients discharged to a facility. The model had a fair fit to the data and demonstrated that younger patients who had more comorbidities, were likely to have more pain. Older patients with more comorbidities, higher injury severity, more days from admission to evaluation, and lower pain were more likely to have a longer LOS which explained 37% of the variance in LOS. Based on logistic regression analysis, having longer LOS (O.R. = .049, 95% CI .008 - .301, p=.001) and more pain (O.R. = .531, 95% CI .310 - .908, p=.021) were associated with decreased likelihood of returning home versus being discharged to a facility. Conclusion: Increased focus on pain and pain management, consideration of comorbidities, and decreasing time from admission to initial evaluation by rehabilitation therapists among older trauma patients may help to decrease LOS and facilitate discharge to the least restrictive setting.
    • Predictors of successful occupational rehabilitation for persons living with disabilities

      Hu, Debbie; Cornelius, Llewellyn Joseph, 1959- (1997)
      This research considers the association between social support, education, and socio-economic status, among other variables and successful occupational rehabilitation for persons living with physical disabilities. Current statistics show unemployment rates for persons with physical disabilities to be as high as 65 percent. Logistic regression analysis was used to analyze a national sample of 32,000 subjects randomly drawn from the public use data from the 1993 Rehabilitation Services Administration's (RSA) Case Reports. Results suggest positive associations between marital status, cost of services provided, previous work status, gender and successful occupation rehabilitation. Married rehabilitation clients, female rehabilitation clients, clients who were previously employed, and clients who received more rehabilitation services during the rehabilitation process were more likely to be successfully rehabilitated. The predictor with the highest level of significance was cost of services provides. This result seems to suggest that those rehabilitation clients who received more services during the course of their rehabilitation process appeared to have benefited more than those who received less services, and were significantly more likely to be successfully rehabilitated.