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Neurological Rehabilitation

The Effect of PM&R Consult on Post-Acute Care Disposition in Acute Ischemic Stroke Patients

Thursday, October 23, 2025
12:45 PM - 2:15 PM MT
Location: Kiosk 10
Disclosure(s):
Dylan C. Tookey, MD: No financial relationships to disclose
Sandra Sanchez, Other: No financial relationships to disclose
Background and/or Objectives: Prior literature shows that post-acute care (PAC) setting leads to significant differences in long term functional outcomes for patients requiring further rehabilitation after hospitalization. In stroke patients, discharge to Acute Rehab Unit (ARU) leads to statistically significant improvements in overall functional outcomes (mobility and self-care) compared to patients discharged to a Skilled Nursing Facility (SNF). Prior literature shows that patients that receive PAC at ARU are more likely to be discharged to their community than those that receive PAC at SNF. Biggest barrier to receiving care at ARU is often acceptance or insurance authorization. Physiatrists are the specialists most familiar with criteria for placement to ARU, therefore their involvement in patient care may make it easier for patients to be placed at ARU for PAC.

Design: Retrospective analysis conducted using data from Scripps Memorial Hospitals, La Jolla and Encinitas. ICD 10 codes were used to identify eligible acute stroke patients. 215 cases identified had Physical Medicine & Rehabilitation (PM&R) consulted and 215 cases with similar comorbidities that did not have PM&R consulted. Chi-squared and T-Tests were used for data analysis of primary and secondary outcome measures.

Setting : Scripps Memorial Inpatient Hospitals, La Jolla and Encinitas

Participants : Participants were patients that presented to one of two Scripps Memorial hospitals with a principal diagnosis of acute ischemic stroke

Interventions: PM&R consultation vs no PM&R consultation

Main Outcome Measures: Disposition location for Post-Acute Care (Acute rehab vs. Skilled nursing facility etc.)

Results: Statistically significant relationship between PM&R consult and disposition location for acute ischemic stroke patients. PM&R was more frequently consulted for patients with more severe strokes as well as greater comorbidity burden.

Conclusions: PM&R consultation is significantly associated with disposition location in acute ischemic stroke patients, with a notable increase in discharges to ARUs when PM&R is consulted.