LTACHs Offer Improved Rehabilitation Services for COVID-19 Patients

The pandemic revealed significant issues for many facets of the health care industry, one of them being how to cope with the increasing number of patients recovering at different rates with different needs. Long-term acute care hospitals (LTACH) are best positioned to deliver rehabilitation services to this population due to their facilities and existing staff training.

Authors of a recent study conducted a single center, retrospective analysis of patients who were treated for COVID-19 and discharged from a short-term acute care hospital and transferred to an LTACH in the Northeastern United States through August 14, 2020.

Research objectives included patient characteristics, clinical management, and patient outcomes. Patient care in the LTACH included usual management of pulmonary and neurological conditions, speech and language pathology, and functional impairments. Care also included modified COVID-19-related protocols for proning, dysphagia, and facility-wide infection control measures.

A total of 117 patients, average age 63 years, 64.1% male, were observed over 148 days with 108 patients being discharged by the time of data cutoff. At time of admission to the LTACH, 29.9% tested positive for SARS-CoV-2. The mean length of stay for the discharged cohort was 25.5 days.

For patients who presented as nonambulatory at admission (n=48), 40 were ambulatory at discharge. This was measured by an average increased gait of 217.4 feet from 146.3 feet.

Over 90% of patients being mechanically vented at admission were weaned before discharge after a mean 11.3 days.

The researchers also observed that 74% of patients who were on a modified diet or eating nothing by mouth at time at admission has resumed at normal diet by their discharge.

“The vast majority of patients treated at a long-term acute care hospital for severe COVID and related complications improved significantly through coordinated care and rehabilitation, including improvements in functional status, cognitive communication abilities, and pulmonary measures, indicating a possible benefit of structured rehabilitation in the post-acute phase of COVID-19,” concluded researchers.

—Edan Stanley

Reference:

Grevelding P, Hrdlicka H, Holland S et al. Outcomes of and Lessons Learned from Patients with Severe COVID-19 in a Long-term Acute Care Hospital. Arch Phys Med Rehabil. 2021;102(4):e3-e4. doi:10.1016/j.apmr.2021.01.013