201 - Correlating Factors for Discharge to Rehabilitation Facilities Following Hospitalization of COVID-19 Patients

Thursday, February 22, 2024

5:00 PM – 6:30 PM EDT

Presenting Author(s)

SJ

Suraj Jain
YA

Yehuda Azerrad, BS

Student Physician
NYITCOM
East Rockaway, New York, United States

Co-Author(s)

YG

Yisroel Grabie, DO

Resident Physician
Staten Island University Hospital
Staten Island, New York, United States
SA

Sudeep Acharya, MD

Fellow Physician
Staten Island University Hospital
Staten Island, New York, United States
SM

Shane McNamara, MD

Resident Physician
Staten Island University Hospital
Staten Island, New York, United States
SH

Stefan Hamaway, MD

Resident Physician
Staten Island University Hospital
Staten Island, New York, United States
AG

Allison Glaser, MD

Attending Physician
Staten Island University Hospital
Staten Island, New York, United States

Objectives: This study explores correlating factors for post-acute discharge to rehabilitation facilities in patients hospitalized with COVID-19.

Design: This is a retrospective analysis on 2771 COVID-19 patients admitted to a hospital system between July 1, 2022, and July 1, 2023. Hospital disposition outcomes were separated into home (2420) versus rehabilitation (351). Multiple variables were analyzed including hospital length of stay (LOS), patient age, clinical biomarkers (peak BUN, first ALT/AST, first procalcitonin, first lactate), and the use of critical care interventions (mechanical ventilation and vasopressors) during hospitalization. Logistical regression was used to identify significant correlation factors for discharge to rehabilitation. Independent t-tests were used to compare values between patients discharged to rehabilitation versus patients discharged home.

Results: Increased hospital LOS significantly correlated with discharge to rehabilitation, with each additional day increasing the odds ratio (OR) by 7.03% (OR 1.0703; 95% CI: 1.05608 to 1.0846). Patient age also significantly correlated to discharge to rehabilitation, with each additional year of age increasing the OR by 2.48% (OR 1.0248; 95% CI: 1.01632 to 1.0333). Higher peak BUN (p < 0.001), first AST (p < 0.032), and first procalcitonin (p < 0.001) were found to be significant. The use of mechanical ventilators and vasopressors were both significantly correlated with post-acute rehabilitation (χ² values of 19.8 and 16.3, respectively, p< .001 for both).

Conclusions: In this retrospective analysis, hospital LOS, patient age, certain clinical biomarkers, and the use of critical care interventions were found to be significantly correlated with a discharge to rehabilitation facilities versus discharge home after inpatient treatment for COVID-19. Optimizing care pathways for these patients using multifactorial parameters is crucial to enhance recovery and alleviate long-term impact of COVID-19.