CLINICAL OUTCOMES

Poster 84Retrospective Analysis of Rivaroxaban VersusFondaparinux for Thromboprophylaxis after JointReplacement at an Inpatient RehabilitationFacility.Abhishek Reddy, DO (Marianjoy Rehabilitation Hospi-tal, Wheaton, IL, United States); Nitika Agarwal, PhD.

Disclosures: A. Reddy, No Disclosures.Objective: The purpose of this study is to compare the effective-ness and safety of the new oral Factor Xa inhibitor rivaroxaban tofondaparinux, an injectable anticoagulant, for prevention of venousthromboembolism (VTE) after hip or knee arthroplasty within aninpatient rehabilitation facility (IRF). Multiple studies reported havecompared rivaroxaban with enoxaparin for thromboprophylaxis;however, there are no studies reported comparing safety and effec-tiveness of rivaroxaban versus fondaparinux.Design: Retrospective cohort study.Setting: Freestanding IRF.Participants: Patients admitted to an IRF during a 12-monthperiod following lower extremity joint replacement who receivedeither rivaroxaban or fondaparinux for VTE prevention.Interventions: Not applicable.Main Outcome Measures: Primary effectiveness outcome in-cluded occurrence of deep-vein thrombosis (DVT) and pulmonaryembolism (PE). Primary safety outcomes were any major or non-major bleeding events. Major bleeding event defined as bleedinginto critical organ, clinically overt bleeding leading to fall in hemo-globin of greater than or equal to 2g/dL or clinically overt bleedingleading to transfusion of 2 or more units of blood. Non-majorbleeding event was defined as clinically relevant non-major bleed-ing, hemorrhagic wound complications or any other bleeding oranemia leading to discontinuation of anticoagulant.Results: In a preliminary analysis of 48 patient records (25 patientson rivaroxaban; 23 patients on fondaparinux), no DVT or PE eventswere recorded. No major bleeding event occurred in patients pre-scribed rivaroxaban compared to 4.3% in patients prescribed fonda-parinux. A minor bleeding event occurred in 4% of patients pre-scribed rivaroxaban compared to 4.3% in fondaparinux group.Conclusions: Data collection is on-going as rivaroxaban is arelatively new oral anticoagulant in the IRF’s formulary. Preliminarystudy results support similar effectiveness and safety with bothanticoagulants in regards to VTE prevention and bleeding events.Additional data analysis will continue across the study period.

Poster 85The Functional Status of Individuals on ChronicOpioid Therapy & the Opioid Therapy’s Efficacyand Therapeutic Effect.Armando S. Miciano, MD (Nevada Rehabilitation Insti-tute, Las Vegas, NV, United States); James G. Marx, MD.

Disclosures: A. S. Miciano, No Disclosures.Objective: The study objectives were to describe the functionalstatus of individuals on chronic opioids (ICO) �1 year and to relateit to efficacy and therapeutic effect derived from the treating physi-cian’s clinical impression.Design: Retrospective study.

Setting: Outpatient pain management clinic.Participants: 81 subjects (39 female; 42 male)Interventions: None.Main Outcome Measures: Subjects completed the Pain Dis-ability Questionnaire (PDQ), a formal assessment of pain-relatedimpairments (PRI) by the AMA Guides Sixth Edition. The PRI wasthen sub-categorized to: Functional Status (FS) and PsychosocialStatus (PS) Components. The treating physician then scored theClinician Global Impressions via the Efficacy Index (CGI-EI) from1-4 to determine whether the chronic opioid therapy (COT) inter-feres with the individual’s functioning (score 1 meaning no interfer-ence with functioning versus score 4 meaning COT outweigh ther-apeutic effect); in addition, Therapeutic Effect (CGI-TE) was alsoscored from 1-4 to record improvement of ICO symptoms (score 1meaning unchanged or worse versus score 4 meaning marked vastimprovement).Results: Total PDQ (maximum score 150) was then stratified byPRI severity and resulted in: 1.0% no impairment; 45.0% mild;25.0% moderate; 20.0% severe; and, 9.0% extreme PRI. PDQ scoresranged from 0-146 (mean 78.0). CGI-EI scores averaged 1.2, andCGI-TE scores averaged 3.4. There was a trend relationship in thePDQ and CGI scores.Conclusions: Most ICO still self-reported mild pain-related im-pairments, and the clinician global impressions indicate that COThad no significant interference with ICO’s functioning and had ledto moderate decided improvement in ICO symptoms. As the studydescribed the functional status of ICO, it delineated the clinicalbenefits of COT. It concludes that the self-reported PDQ and CGIassessment by professionals are useful together in assessing thecurrent pain status of chronic opioid users. Further correlative studyon the PDQ and CGI scores would be beneficial.

Poster 86Correlates of Self-Reported Disability in Individualswith Chronic Low Back Pain: The Role of Multi-Morbidity Burden, Functional Status, and GlobalHealth.Armando S. Miciano, MD (Nevada Rehabilitation Insti-tute, Las Vegas, NV, United States); Jacqueline Derhou-soff; Chad Cross, PhD, PStat(R).

Disclosures: A. S. Miciano, No Disclosures.Objective: This study aims to recommend easy, reproducibleand valid self-report questionnaires to allow a functional assessmentof chronic low back pain (CLBP) patients; it examined the determi-nants of self-reported disability in patients with CLBP and measuredtheir functional status level owing to pain-related impairment (PRI),multi-morbidity burden, and global health scores in an ambulatoryclinical population.Design: A retrospective study.Setting: Outpatient PM&R clinic.Participants: 40 patients (male 50%).Interventions: n/a.Main Outcome Measures: The data included: self-reporteddisability by Modified Oswestry Low Back Pain Disability Question-naire (MODQ) and by Roland-Morris Low Back Pain Questionnaire(RMQ), functional status due to PRI by Pain Disability Question-naire (PDQ), multi-morbidity burden by Self-Administered Co-Morbidity Questionnaire (SCQ), and global health by PROMIS-57Physical Function (PF) & Pain Impact (PI) subscales.

S218 PRESENTATIONS