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Disability and length of stay of hospitalized older adults experiencing adverse events in postacute rehabilitation care: a prospective observational study.

BACKGROUND
Although the literature provides insight into negative consequences among individuals who experience adverse events in acute hospitals, the relationship between adverse events and their consequences in older adults receiving post--acute rehabilitation care remains unexplored.


AIM
The current study aims to assess the relationship between adverse events and disability at discharge or prolonged stay in inpatient rehabilitation programs.


DESIGN
Prospective cohort study.


SETTING
Rehabilitation unit of a French public hospital.


POPULATION
A cohort of inpatients (216 older adults) admitted to a rehabilitation unit.


METHODS
The occurrences of any adverse event or persisting associated injury were reported. The length of hospital stay during the rehabilitation program was assessed and compared with a standard stay. The level of disability for mobility activities was estimated with the disability qualifiers from the International Classification of Functioning, Disability and Health. Baseline--measured covariates were also selected.


RESULTS
A total of 26 participants (12.0%) experienced at least 1 adverse event during their hospital stay. Experiencing either fall--related events or any other kind of adverse event was independently associated with moderate--severe disability (odds--ratios: 6.40 and 8.42, respectively) and with prolongation of stay (odds--ratios: 5.76 and 4.43, respectively) after adjusting for baseline confounders.


CONCLUSION
Older adults who experienced or maintained injuries from adverse events during their rehabilitation stay had more frequently moderate or severe disability in mobility activities and a prolonged hospital stay.


CLINICAL REHABILITATION IMPACT
Data suggest that efforts to prevent the occurrence of these events, as well as early interventions, may have a positive influence on the consequences from adverse events. Further studies should evaluate disability over time, before and after discharge, to obtain a better sense of how transient or permanent the associated disability may be.