Pressure injuries, obesity and mental health concerns on admission to rehabilitation are associated with increased orthopaedic rehabilitation length of stay
Ali Lakhani & Leslie Gan
Objective: To investigate the association between a set of comprehensive factors across international literature and rehabilitation length of stay.
Method: A chart audit of 197 Australian hospital rehabilitation unit orthopaedic inpatients (2016–2018) was conducted. Items significantly associated with length of stay throughout univariate regressions were entered into a subsequent hierarchical multiple regression analysis, where variables were regressed against length of stay in two steps. Items which were relevant prior to admission to the rehabilitation unit, or immediately upon admission, were regressed against length of stay during the first step, while variables which emerged during admission were entered during the second step.
Results: Having pressure injuries during rehabilitation (p < .001), limited compliance in rehabilitation programs (p = .007), mental health concerns on admission to rehabilitation (p = .007), being obese (p < .001), and having significant pain impacting function (p = .03) were all independently significantly associated with an increased length of stay. Higher Functional Independence Measure motor (p < .001) subscale scores on admission to rehabilitation were associated with decreased length of stay. A hierarchical multiple regression analysis found that pressure injuries during rehabilitation (p = .002), being obese (p = .04), having mental health concerns on admission to rehabilitation (p = .03), and Functional Independence Measure subscale scores on admission (p = .04) were significantly associated with length of stay.
Conclusion: It is imperative that clinical programs and interventions promoting mental health outcomes, and addressing the distinct needs of obese inpatients, are delivered in the rehabilitation context.