S234 PRESENTATIONS

Objective: To compare patients’ demographic and treatmentfactors, health-related quality of life factors, and cancer-relatedsymptoms between high- and low-burden caregivers of patientswith malignant brain tumors.Design: Prospective, longitudinal cohort study.Setting: Interdisciplinary outpatient rehabilitation program at sixaffiliated rehabilitation sites.Participants: Study group of 26 consecutive adult patients andtheir caregivers with malignant brain tumors enrolled in dayrehabilitation over 14 months.Interventions: These patients received comprehensive outpatienttherapies, including physical therapy, occupational therapy, andspeech language pathology, ranging from 3 half days/week (3hours/day) to 5 full days (6 hours/day). Other services offeredincluded psychology, nursing, and physician oversight.Main Outcome Measures: Brief version of the Zarit BurdenInterview (ZBI). Patients’ demographic and cancer-related treat-ments and co-morbidities including gender, type of brain tumor,ongoing radiation or chemotherapy, use of antidepressants,steroids, or antiseizure medications, or comorbidities of diabetesmellitis, hypertension, seizures, mood disorder, or deep veinthromboses (DVT).Results or Clinical Course: Caregivers were divided into twogroups, high- and low-burden, using a cutoff score of ZBI >¼17that is suggestive of clinically significant caregiver burden. Patientsbeing cared for by the high-burden caregivers were likely to havemore co-morbidity of Deep Venous Thrombosis (p¼.03), nonGlioblastoma Multiforme tumor (p¼.04), and more pain (p¼.01) atdischarge. All (100%) high-burden caregivers at discharge main-tained their high-burden membership at 1-month follow-upwhereas 22.2% of low-burden caregivers at discharge moved tohigh-burden membership at 1-month follow-up.Conclusions: Morbidity and pain issues are contributory factorsassociated with burden of caregivers who provide care to patientswith malignant brain tumors. Many caregivers have difficultycoping with stress or role demands associated with the caring oftheir relatives with malignant brain tumors. An interdisciplinaryoutpatient rehabilitation program for malignant brain tumorpatients must address symptoms of pain and co-morbidity toimprove outcomes. This study further shows that more follow upinterventions are needed aimed at reducing burden of caregiversafter discharge.

Poster 143A Comparison Study of Rehabilitation Outcomes byFacility Size Among Inpatient RehabilitationFacilities.Margaret A. DiVita, MS, PhD (State University of New Yorkat Cortland, Cortland, NY, United States);Jacqueline M. Mix, MPH; Paulette Niewczyk, MPH, PhD;Carl V. Granger, MD.

Disclosures: M. A. DiVita, UDSMR, Employment (full or part-time)Objective: To compare rehabilitation related outcomes amongstinpatient rehabilitation facilities (IRFs) by size of the facility.Design: A retrospective cohort study using data from the UniformData System for Medical Rehabilitation (UDSMR): cases dischargedin calendar year 2012.Setting: IRFs

Participants: 423,320 patients from 835 IRFs were included.Facility size was determined by bed size; small (9 or fewer beds,n ¼ 48), medium (10 to 19 beds, n ¼ 303) and large (20 or morebeds, n ¼ 484).Interventions: Not applicable.Main Outcome Measures: Rehabilitation related outcomeswere compared; they included: case mix index (CMI), admissionFIM� average, discharge FIM� average, FIM� change, rehabilita-tion length of stay, onset days and discharge setting.Results or Clinical Course: The lower the bed size of a facility,the lower the CMI, 1.18, 1.20, and 1.30 for small, medium andlarge, respectively. When adjusted for case mix group (CMG), thesmaller facilities had a higher admission FIM� average whencompared to the medium and larger facilities, 66.8 vs. 63.3 and63.3, respectively. Subsequently, the smaller facilities had a lowerFIM� gain average, 25.6 vs. 27.3 and 28.1. Length of stay, onsetdays and discharge percentage to the community were similarbetween all groups, when adjusted for CMG. The smaller facilitieshad a higher discharge percentage to a long-term care hospital thanthe medium or large facilities (9.3 vs. 7.0% and 6.8%).Conclusions: The results suggest that larger facilities may havebetter rehabilitation related outcomes, in particular functional gainsand fewer patients discharged to a non-community setting whencompared to facilities with 9 or fewer beds. However, thesedifferences were not very large and may not be clinically significant.

Poster 144Utilizing AcuteFIM� Instrument in PredictingDischarge Destination for Stroke Patients from theAcute Hospital Setting.Pamela Roberts, PhD, MSHA, OTR/L, CPHQ (Cedars-SinaiMedical Center, Los Angeles, CA, United States);Jacqueline M. Mix, MPH; Richard V. Riggs, MD;Carl V. Granger, MD; Paulette Niewczyk, MPH, PhD.

Disclosures: P. Roberts, No Disclosures: I Have No RelevantFinancial Relationships to Disclose.Objective: There is increasing need to demonstrate quality andcost effectiveness across the continuum of care. The AcuteFIM�instrument is a functional measure derived from the FIM� instru-ment for use in the acute care setting. This study examines thevalidity and reliability of the AcuteFIM� instrument assessed onstroke patients admitted to an acute care hospital.Design: Prospective Cohort Study.Setting: Acute Hospital, Inpatient Rehabilitation Facilities (IRFs).Participants: 423 stroke patients admitted to an acute unitbetween January 1, 2013, and September 30, 2013. A total of 54patients received additional services at an IRF and their admissionFIM� total rating was assessed in the IRF.Interventions: Not applicable.Main Outcome Measures: Spearman’s correlation coefficientswere used to calculate inter-item correlations of the AcuteFIM�instrument. Reliability was evaluated by calculating Cronbach’sAlpha. The ability of the AcuteFIM� instrument to predictdischarge destination from the acute unit was evaluated by calcu-lating a c-statistic using logistic regression. The ability of Acute-FIM� instrument to predict Admission FIM� total was examinedusing linear regression.Results or Clinical Course: A total of 231 patients hadischemic stroke (55%), 71 had hemorrhagic stroke (71%), 117 had