Aims:
Investigate the association of the Charlson Comorbidity Index (CCI) with Functional Independence Measure (FIM), length of stay (LOS) and discharge destination (DD) in geriatric admittees to the Osborne Park Hospital (OPH) - Stroke Rehabilitation Unit (SRU).
Methods:
We extracted registry data for randomly sampled (23.7%, n=400/1,687) SRU admittees ≥65 years-old from 2010 to 2024. Associations between CCI scores (continuous) with FIM, FIM-Change, LOS, and DD were assessed with multivariate-adjusted (a) linear (β) and logistic (OR) regression with 95% confidence intervals (95% CIs).
Results:
Included patients (95.8%, n=383/400), average 80.92±7.63 years-old, 62.9% female, and home-residing (95.0%), in metropolitan areas (91.9%).
At admission, average CCI was 2.42±2.01, with high prevalence of cardiovascular disease (82.5%), including stroke (44.4%); modified Rankin Scale (mRS) was 4.05±0.70; FIM was 63.65±24.95, FIM-Motor was 42.36±20.37, and FIM-Cognitive was 21.29±7.66.
At discharge, CCI associated with lower total (aβ: -1.56, 95%CI: -2.77, -0.36), motor (aβ: -1.06, 95%CI: -2.06, -0.07), cognitive (aβ: -0.50, 95%CI: -0.86, -0.14) FIM, and DD home (CCI score -aOR: 0.86, 95%CI: 0.77, 0.97), all P<0.05. Dementia (aβ: -11.69, 95%CI: -17.80, -5.58) independently associated with lower discharge FIM, P<0.05.
Conclusions:
Higher CCI scores are associated with reduced FIM and fewer discharged home. Prevalent dementia was independently associated with reduced discharge FIM. The data suggests that higher comorbidity and patients with dementia have worse functional recovery, higher healthcare utilisation and more reliance on services beyond returning home.