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Poster 103 Analyzing Vitamin D Status in an Inpatient Rehabilitation Population and Its Relationship to Outcome Measurement
PM&R
appear to be involved, possibly mechanical, neuropathic or socioeconomic variables. Variability among surgeons and the presence of FAC may be due to differences in practice profiles or sampling error. This marker may represent a target for pain relief or assist in predicting response to interventions. Poster 103 Analyzing Vitamin D Status in an Inpatient Rehabilitation Population and Its Relationship to Outcome Measurement. MIchael Olds, (Kingsbrook Jewish Medical Center, Brooklyn, NY, United States); Guido Mascialino, PhD; Marc K. Ross, MD. Disclosures: M. Olds, No Disclosures. Objective: To analyze the prevalence of low vitamin D levels in inpatient rehabilitation, determine if low levels correlate with rehab outcome, and determine if any demographic variables are risk factors for low serum vitamin D. Design: 25(OH) vitamin D serum levels were ordered on all inpatient rehabilitation admissions for May and June 2011. Patient information reviewed included vitamin D level, age, sex, ethnicity, diagnosis, therapy attendance, and FIM measurements. Setting: Acute inpatient rehabilitation unit of an acute care hospital located in Brooklyn, NY. Participants: 91 total acute rehab admissions had serum 25(OH) vitamin D level collected. Interventions: We conducted Pearson correlations between vitamin D level & FIM change score and vitamin D level & age, and an ANOVA between vitamin D level & gender. Main Outcome Measures: Males - 47.3%, Females - 52.7%, Deficient - 16.6%, Insufficient - 63.7%, Sufficient - 19.7%, AfricanAmericans - 82.4%, Hispanics - 6.6%, Caucasians - 6.6%, Asians 1.1%, Other ethnicity - 2.2%, Unknown ethnicity - 1.1%, Mean age - 66.6, Mean FIM initial - 58.66, Mean FIM discharge - 82.93, Mean FIM change - 24.27, Mean PT/OT therapy days - 12.4. Results: Vitamin D level & age: .429 (P value⫽.000), Vitamin D level & PT/OT therapy days: -.077 (P value⫽.497), Vitamin D level & FIM discharge: -.006 (P value⫽.957), Vitamin D level & FIM initial: .003 (P value⫽.980), Vitamin D level & FIM change: -.012 (P value⫽.912), ANOVA Between groups: F⫽ 5.373, P value⫽.23. Conclusions: The only studied variables that correlate with vitamin D levels are age and gender (F ⫽ 5.37, P⫽.023). As patients aged their vitamin D levels were higher and women had higher levels than men. No associations between vitamin D levels and rehab outcome measures were found. Poster 104 Changes in Calls to Poison Centers for Oxycodone and Heroin After Introduction of a Reformulated Extended-Release Oxycodone Tablet. Paul Coplan, ScD (Purdue Pharma, Stamford, CT, United States); Howard Chilcoat, ScD; Hrishikesh Kale, MS; Lauren Sandstrom, MBA. Disclosures: P. Coplan, Employment, Purdue Pharma. Objective: To assess changes in the number of calls to poison centers reporting problems from exposure (“exposures”) to Purdue Pharma’s extended-release (ER) oxycodone, other single-entity (SE) oxycodone and heroin from before to after introduction of reformulated ER oxycodone (ORF).
Vol. 4, Iss. 10S, 2012
S225
Design: Longitudinal observational study of number of poison center exposures before and after reformulation. Setting: Purdue reformulated ER oxycodone to have physicochemical barriers to crushing and dissolving and limited shipments of ER oxycodone to ORF after August 2010. Original ER oxycodone availability decreased but remained limitedly available during this assessment. Changes in numbers of exposures were assessed from before (July 2009 to June 2010) to after (October 2010 to June 2011) ORF introduction. Participants: U.S. population covered by 61 poison centers. Interventions: Introduction of ORF in August 2010. Main Outcome Measures: Trends in exposures for Purdue’s ER oxycodone tablets, other SE oxycodone and heroin. Results: Exposures for all reasons decreased by 19% for Purdue’s ER oxycodone (693 to 568 cases per quarter), increased 13% for other SE oxycodone (1509 to 1705 per quarter) and increased 17% (587 to 688 per quarter) for heroin from before to after ORF availability. Exposures resulting from abuse decreased by 25% for ER oxycodone, increased 17% for other SE oxycodone and increased 21% for heroin. Unintentional therapeutic error exposures decreased 13% for ER oxycodone and increased 10% for other SE oxycodone. Data assessed from a comparative time period one year earlier (7/2008 to 6/2009 vs. 10/2009 to 6/2010) indicated that exposures for all reasons increased 8% for ER oxycodone, increased 11% for other SE oxycodone and increased 5% for heroin. Conclusions: Poison centers exposures to Purdue’s ER oxycodone tablets decreased after ORF introduction, for all reasons and for the specific reasons of abuse and patient therapeutic error. In the same period, exposures to other SE oxycodone and heroin increased. Longer follow up is needed and is ongoing. Poster 105 The Impact of Comorbidities and Complications on Burn Injury Inpatient Rehabilitation Outcomes. Paul Gerrard, MD (Spaulding Rehabilitation Hospital, Boston, MA, United States); Margaret A. DiVita, MS; Richard Goldstein, PhD; Karen J. Kowalske, MD; Paulette Niewczyk, MPH, PhD; Colleen M. Ryan, MD; Jeffrey C. Schneider, MD; Ross D. Zafonte, DO. Disclosures: P. Gerrard, No Disclosures. Objective: The objective of this study is to examine the impact of comorbidities and complications on burn IRF outcomes. Design: Retrospective cross-sectional study. Setting: Inpatient rehabilitation hospitals. Participants: A total of 4572 patients with a primary diagnosis of burn injury from the Uniform Data System for Medical Rehabilitation database from 2002 to 2010. Interventions: Regression analyses are used to determine if three different comorbidity measures (Charlson Comorbidity Index, Elixhauser Comoribidity Index, CMS Comorbidity Tiers) and one complication measure improve the predictive model (c-statistic) for each outcome measure. Main Outcome Measures: Community discharge, FIM® gain, length of stay efficiency, transfer to acute care within the first 3 days of IRF stay and transfer to acute care for all time periods. Results: For all outcomes there was no difference between the Standard Model and the models that include the comorbidity and complication variables as measured by the c-statistic confidence intervals.
appear to be involved, possibly mechanical, neuropathic or socioeconomic variables. Variability among surgeons and the presence of FAC may be due to differences in practice profiles or sampling error. This marker may represent a target for pain relief or assist in predicting response to interventions. Poster 103 Analyzing Vitamin D Status in an Inpatient Rehabilitation Population and Its Relationship to Outcome Measurement. MIchael Olds, (Kingsbrook Jewish Medical Center, Brooklyn, NY, United States); Guido Mascialino, PhD; Marc K. Ross, MD. Disclosures: M. Olds, No Disclosures. Objective: To analyze the prevalence of low vitamin D levels in inpatient rehabilitation, determine if low levels correlate with rehab outcome, and determine if any demographic variables are risk factors for low serum vitamin D. Design: 25(OH) vitamin D serum levels were ordered on all inpatient rehabilitation admissions for May and June 2011. Patient information reviewed included vitamin D level, age, sex, ethnicity, diagnosis, therapy attendance, and FIM measurements. Setting: Acute inpatient rehabilitation unit of an acute care hospital located in Brooklyn, NY. Participants: 91 total acute rehab admissions had serum 25(OH) vitamin D level collected. Interventions: We conducted Pearson correlations between vitamin D level & FIM change score and vitamin D level & age, and an ANOVA between vitamin D level & gender. Main Outcome Measures: Males - 47.3%, Females - 52.7%, Deficient - 16.6%, Insufficient - 63.7%, Sufficient - 19.7%, AfricanAmericans - 82.4%, Hispanics - 6.6%, Caucasians - 6.6%, Asians 1.1%, Other ethnicity - 2.2%, Unknown ethnicity - 1.1%, Mean age - 66.6, Mean FIM initial - 58.66, Mean FIM discharge - 82.93, Mean FIM change - 24.27, Mean PT/OT therapy days - 12.4. Results: Vitamin D level & age: .429 (P value⫽.000), Vitamin D level & PT/OT therapy days: -.077 (P value⫽.497), Vitamin D level & FIM discharge: -.006 (P value⫽.957), Vitamin D level & FIM initial: .003 (P value⫽.980), Vitamin D level & FIM change: -.012 (P value⫽.912), ANOVA Between groups: F⫽ 5.373, P value⫽.23. Conclusions: The only studied variables that correlate with vitamin D levels are age and gender (F ⫽ 5.37, P⫽.023). As patients aged their vitamin D levels were higher and women had higher levels than men. No associations between vitamin D levels and rehab outcome measures were found. Poster 104 Changes in Calls to Poison Centers for Oxycodone and Heroin After Introduction of a Reformulated Extended-Release Oxycodone Tablet. Paul Coplan, ScD (Purdue Pharma, Stamford, CT, United States); Howard Chilcoat, ScD; Hrishikesh Kale, MS; Lauren Sandstrom, MBA. Disclosures: P. Coplan, Employment, Purdue Pharma. Objective: To assess changes in the number of calls to poison centers reporting problems from exposure (“exposures”) to Purdue Pharma’s extended-release (ER) oxycodone, other single-entity (SE) oxycodone and heroin from before to after introduction of reformulated ER oxycodone (ORF).
Vol. 4, Iss. 10S, 2012
S225
Design: Longitudinal observational study of number of poison center exposures before and after reformulation. Setting: Purdue reformulated ER oxycodone to have physicochemical barriers to crushing and dissolving and limited shipments of ER oxycodone to ORF after August 2010. Original ER oxycodone availability decreased but remained limitedly available during this assessment. Changes in numbers of exposures were assessed from before (July 2009 to June 2010) to after (October 2010 to June 2011) ORF introduction. Participants: U.S. population covered by 61 poison centers. Interventions: Introduction of ORF in August 2010. Main Outcome Measures: Trends in exposures for Purdue’s ER oxycodone tablets, other SE oxycodone and heroin. Results: Exposures for all reasons decreased by 19% for Purdue’s ER oxycodone (693 to 568 cases per quarter), increased 13% for other SE oxycodone (1509 to 1705 per quarter) and increased 17% (587 to 688 per quarter) for heroin from before to after ORF availability. Exposures resulting from abuse decreased by 25% for ER oxycodone, increased 17% for other SE oxycodone and increased 21% for heroin. Unintentional therapeutic error exposures decreased 13% for ER oxycodone and increased 10% for other SE oxycodone. Data assessed from a comparative time period one year earlier (7/2008 to 6/2009 vs. 10/2009 to 6/2010) indicated that exposures for all reasons increased 8% for ER oxycodone, increased 11% for other SE oxycodone and increased 5% for heroin. Conclusions: Poison centers exposures to Purdue’s ER oxycodone tablets decreased after ORF introduction, for all reasons and for the specific reasons of abuse and patient therapeutic error. In the same period, exposures to other SE oxycodone and heroin increased. Longer follow up is needed and is ongoing. Poster 105 The Impact of Comorbidities and Complications on Burn Injury Inpatient Rehabilitation Outcomes. Paul Gerrard, MD (Spaulding Rehabilitation Hospital, Boston, MA, United States); Margaret A. DiVita, MS; Richard Goldstein, PhD; Karen J. Kowalske, MD; Paulette Niewczyk, MPH, PhD; Colleen M. Ryan, MD; Jeffrey C. Schneider, MD; Ross D. Zafonte, DO. Disclosures: P. Gerrard, No Disclosures. Objective: The objective of this study is to examine the impact of comorbidities and complications on burn IRF outcomes. Design: Retrospective cross-sectional study. Setting: Inpatient rehabilitation hospitals. Participants: A total of 4572 patients with a primary diagnosis of burn injury from the Uniform Data System for Medical Rehabilitation database from 2002 to 2010. Interventions: Regression analyses are used to determine if three different comorbidity measures (Charlson Comorbidity Index, Elixhauser Comoribidity Index, CMS Comorbidity Tiers) and one complication measure improve the predictive model (c-statistic) for each outcome measure. Main Outcome Measures: Community discharge, FIM® gain, length of stay efficiency, transfer to acute care within the first 3 days of IRF stay and transfer to acute care for all time periods. Results: For all outcomes there was no difference between the Standard Model and the models that include the comorbidity and complication variables as measured by the c-statistic confidence intervals.