In-hospital Rehabilitation Therapy Outcomes in Adult Down’s Syndrome Patients with Community-acquired Pneumonia: A Nationwide Observational Study

Abstract

There has been no analysis of the effects of in-hospital rehabilitation on adult patients with Down's Syndrome (DS) after hospitalization for community-acquired pneumonia (CAP). Medical claims data retrospectively collected nationwide were used to examine outcomes at discharge. Methods: Hospitalization data were obtained from 440 Japanese hospitals for DS patients with CAP that were discharged between 1 June 2009 and 31 January 2022 (n=2897). After the exclusion of 2478 patients, mainly on the basis of age or type of admission, the records of 419 patients were extracted. The following were used as outcomes: (1) 30-day readmission, (2) 45-day readmission, (3) discharge Barthel Index (BI), (4) BI score gain, and (5) length of hospital stay. The targeted minimum loss-based estimator was used to examine effects of the average daily times of rehabilitation on outcomes at discharge. Results: Most patients had no in-hospital rehabilitation (73.5%). Provided that the average daily time of rehabilitation therapy was at least 20 min, BI scores were lower at discharge (coefficient, −15.91; 95% confidence interval, −30.07 to −1.75) and BI gain was lower (coefficient, −12.56; 95% confidence interval, −25.60 to 0.47) when compared with the use of no rehabilitation therapy. Conclusions: In-hospital rehabilitation medicine in DS patients with CAP provided by a therapist was not associated with improved activities of daily living at discharge. Future studies are warranted to develop systematic, efficient, and comprehensive rehabilitation medicine for DS patients suffering from CAP.