Anemia and Rehabilitation Outcomes in Patients Undergoing Convalescent Rehabilitation

Abstract

Objective: Assessment of the association between anemia and recovery of physical disability in patients with functional impairment.

Design: A retrospective cohort study.

Setting: A convalescent rehabilitation ward.

Participants: The subjects were patients undergoing convalescent rehabilitation due to neurologic disease, musculoskeletal disorders, or hospital-associated deconditioning. Patients were classified into 3 groups (no anemia; mild anemia [men: hemoglobin of 11.0-12.9 g/dL; women: hemoglobin of 11.0-11.9 g/dL]; and moderate/severe anemia [hemoglobin < 11.0 g/dL]) based on hemoglobin levels.

Interventions: Not applicable.

Main outcome measures: The study outcomes were functional independence measures for motor function (FIM-M) score at discharge, changes in the FIM-M score between hospital admission and discharge, length of stay, and FIM-M efficiency score (change in FIM-M score divided by length of stay). A linear regression model was constructed to explore the association of anemia with the FIM-M efficiency score. As a subgroup analysis, we constructed a linear regression model to explore the association of anemia with the FIM-M efficiency score in patients with or without stroke.

Results: Of 376 consecutive patients with a mean age of 80 years, 258 (69%) had mild or moderate/severe anemia. There were no significant differences between the 3 groups in the FIM-M score at discharge, changes in the FIM-M score, length of stay, and FIM-M efficiency score. A multiple linear regression model showed that the FIM-M efficiency score was not associated with anemia (mild anemia group: β=-0.02, P=.8; moderate/severe anemia group: β=-0.005, P=.9). In the subgroup analysis of patients with or without stroke, the multiple regression model also showed no significant association between anemia and FIM-M efficiency score in each group.

Conclusions: Anemia on admission was common among patients in a convalescent rehabilitation ward but was not associated with improvement of FIM-M after rehabilitation.

Keywords: Activities of daily living; Anemia; Convalescent rehabilitation; Functional independence measure for motor function; Length of stay.