Incidence and outcome of interrupted geriatric rehabilitation requiring acute hospital transfer

  • Christopher N. OsuaforEmail author
  • Syazwani N. M. Sahimi
  • Sree Enduluri
  • Frances McCarthy
Brief Report


Background and aims

Elderly rehabilitation programs provide a period of rehabilitation to optimize a safe home discharge after acute hospitalization of older adults. Often, these patients may have their rehabilitation interrupted when they become unwell and subsequently require transfer back to an acute hospital setting. We will look at the incidence and outcome of this interruption. This paper aimed to determine the incidence of interrupted post-acute geriatric rehabilitation requiring acute hospital transfer and to analyze the outcome of the transfers.


An analysis of a retrospective cohort of elderly patients admitted into a 22-bed community-based geriatric rehabilitation unit over a 48-month period.


Five hundred thirty-nine patients were admitted for rehabilitation. Fifty (9.3%) patients had their rehabilitation interrupted and were transferred to an acute hospital setting. Sixty-six percent were females; mean age 82.1 ± 8.7 years. Final diagnosis was acute severe infections (44%), traumatic fracture secondary to fall (10%), intraabdominal complications (10%), cardiac complications (8%), and acute neurological event (6%). Of these patients, 42% had a fatal outcome while 32% returned for rehabilitation.


Interrupted geriatric rehabilitation requiring acute hospital transfer occurred in 9.3% of patients; acute severe infection was the most common cause. These transfers were associated with significant mortality. Rehabilitation programs should focus improvement efforts on identifying suitable patients for rehabilitation, optimizing care transitions, and minimizing rates of transfers.


Comorbidity Elderly Patient transfer Rehabilitation 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Informed consent

For this type of study, formal consent is not required.

Ethical approval

For this service evaluation study, ethical approval was not required in our institution.


  1. 1.
    Covinsky KE, Palmer RM, Fortinsky RH, Counsell SR, Stewart AL, Kresevic D, Burant CJ, Landefeld CS (2003) Loss of independence in activities of daily living in older adults hospitalized with medical illnesses: increased vulnerability with age. J Am Geriatr Soc 51:451–458CrossRefGoogle Scholar
  2. 2.
    Health Service Executive, Royal College of Physicians of Ireland (2011) National Clinical Programme for older people: special geriatric services model of care. Dublin. Available at Accessed 10 March 2018
  3. 3.
    Osuafor CN, Salawu A, McCarthy F (2018) A retrospective audit of an elderly rehabilitation service. How effective are we? Ir Med J 111(8):810Google Scholar
  4. 4.
    Downey LV, Zun LS, Burke T (2014) Patient transfer from a rehabilitation hospital to an emergency department: a retrospective study of an American trauma centre. Ann Phys Rehabil Med 57:193–199CrossRefGoogle Scholar
  5. 5.
    O’Toole R, O’Neill D, Collins R et al (2012) Risk of rehospitalisation from an “off-site” rehabilitation unit for older adults. Ir Med J 105(8):285Google Scholar
  6. 6.
    Mas MA, Renom A, Vazquez O, Miralles R, Bayer AJ, Cervera AM (2009) Interruptions to rehabilitation in a geriatric rehabilitation unit: associated factors and consequences. Age Ageing 38(3):346–349CrossRefGoogle Scholar
  7. 7.
    Oliver D (2007) Preventing falls and fall injuries in hospital: a major risk management challenge. Clin Risk 13:173–178CrossRefGoogle Scholar
  8. 8.
    Charlson ME, Pompei P, Ales KL, MacKenzie CR (1987) A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis 40:373–383CrossRefGoogle Scholar
  9. 9.
    Middleton A, Graham JE, Krishnan S, Ottenbacher KJ (2016) Program interruptions and short-stay transfers represent potential targets for inpatient rehabilitation care-improvement efforts. Am J Phys Med Rehabil 95(11):850–861CrossRefGoogle Scholar
  10. 10.
    Heim N, Rolden H, van Fenema EM, Weverling - Rijnsburger AWE, Tuijl JP, Jue P, Oleksik AM, de Craen AJM, Mooijaart SP, Blauw GJ, Westendorp RGJ, van der Mast RC, van Everdinck IEC (2016) The development, implementation and evaluation of a transitional care programme to improve outcomes of frail older patients after hospitalization. Age Ageing 45:642–651CrossRefGoogle Scholar

Copyright information

© Royal Academy of Medicine in Ireland 2019

Authors and Affiliations

  1. 1.Department of Medicine for the ElderlySt Mary’s HospitalDublinIreland
  2. 2.Department of Medicine for the ElderlyAddenbrookes HospitalCambridgeUnited Kingdom
  3. 3.University College DublinBelfieldIreland

Personalised recommendations