{"id":22048,"date":"2025-06-30T10:54:35","date_gmt":"2025-06-30T14:54:35","guid":{"rendered":"https:\/\/www.ices.on.ca\/?post_type=journal_article&#038;p=22048"},"modified":"2025-07-03T16:44:35","modified_gmt":"2025-07-03T20:44:35","slug":"effectiveness-of-inpatient-rehabilitation-for-older-adults-soon-after-dialysis-initiation-for-improving-health-outcomes","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/effectiveness-of-inpatient-rehabilitation-for-older-adults-soon-after-dialysis-initiation-for-improving-health-outcomes\/","title":{"rendered":"Effectiveness of inpatient rehabilitation for older adults soon after dialysis initiation for improving health outcomes"},"content":{"rendered":"<p><strong>Rationale and objective<\/strong> \u2014 Multiple studies have shown that older adults\u2019 initiation of dialysis is associated with functional decline often within months of starting treatment. This functional impairment has been associated with a 2- to 4-fold higher risk of mortality and morbidity. This study sought to assess if rehabilitation within the first few months after starting dialysis may improve physical function and reduce the rates of hospitalization and mortality.<\/p>\n<p><strong>Study design<\/strong> \u2014 Retrospective matched cohort study.<\/p>\n<p><strong>Setting and participants<\/strong> \u2014 Individuals in Ontario, Canada, aged \u226566 years initiating maintenance dialysis whose healthcare data were recorded by ICES, which captures administrative health data for the population of Ontario.<\/p>\n<p><strong>Exposure<\/strong> \u2014 Inpatient rehabilitation care within 6 months of starting dialysis.<\/p>\n<p><strong>Outcomes<\/strong> \u2014 Change in the Functional Independence Measure (FIM\u00ae) score during the rehabilitation hospitalization among those receiving rehabilitation. Counts of hospital days, rates of admission to hospitals and long-term care facilities, and mortality over one year following the index date for comparisons of those who received rehabilitation to those who did not.<\/p>\n<p><strong>Analytical approach<\/strong> \u2014 Patients receiving rehabilitation and three times as many not receiving rehabilitation were matched using a propensity score logistic regression model. Outcomes among those who did and did not receive rehabilitation were compared using Cox proportional hazards models and the Cochran-Mantel-Haenszel test for binary outcomes.<\/p>\n<p><strong>Results<\/strong> \u2014 Among those undergoing rehabilitation, FIM\u00ae scores improved from 76\u00b117 at admission, to 98\u00b119 by discharge (p&lt;0.0001). 1287 of 1567 (82%) patients admitted for rehabilitation within 6 months of dialysis were matched to 3861 patients who did not receive rehabilitation. Patients undergoing rehabilitation had similar 1-year mortality rates to the matched comparison population (27% vs. 25%, p=0.45), but higher hospitalization rates and length-of-stay. Six percent of patients in both groups were admitted to a long-term care facility within the 1-year follow-up (P=0.65).<\/p>\n<p><strong>Limitations<\/strong> \u2014 Potential for residual confounding due to the use of administrative data.<\/p>\n<p><strong>Conclusions<\/strong> \u2014 These data suggest that patients may benefit physically from rehabilitation around the time of starting dialysis. Hospitalization was slightly higher in those undergoing rehab, however unlike previously published data on those with low baseline functional status, mortality was similar across both groups.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Rationale and objective \u2014 Multiple studies have shown that older adults\u2019 initiation of dialysis is associated with functional decline often within months of starting treatment. This functional impairment has been associated with a 2- to 4-fold higher risk of mortality and morbidity. This study sought to assess if rehabilitation within the first few months after [&hellip;]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[49,17,36],"migration-helper-qa-sample-set":[],"class_list":["post-22048","journal_article","type-journal_article","status-publish","hentry","topic-kidney-disease","topic-older-people","topic-rehabilitation"],"acf":{"citation":"Van Loon I, Kajawo S, McArthur E, Nash DM, Rodrigues LF, Dixon SN, Garg AX, Fleet JL, Welk B, Jassal SV. <em>Am J Kidney Dis<\/em>. 2025; S0272-6386(25)00921-7. Epub 2025 Jun 30.","source_url":"https:\/\/doi.org\/10.1053\/j.ajkd.2025.06.003","ices_scientist":[20188,1208,1242,1131],"site":[6739],"research_program":[6743],"news_release":"","journal_article":"","atlas":"","research_report":"","infographic":"","video":"","downloads":null,"links":null,"sitecore_item_id":"","sitecore_item_name":"","sitecore_field_values":"","previous_url":""},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>ICES | Effectiveness of inpatient rehabilitation for older adults soon after dialysis initiation for improving health outcomes<\/title>\n<meta name=\"description\" content=\"Rationale and objective \u2014 Multiple studies have shown that older adults\u2019 initiation of dialysis is associated with functional decline often within months\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/effectiveness-of-inpatient-rehabilitation-for-older-adults-soon-after-dialysis-initiation-for-improving-health-outcomes\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"ICES | Effectiveness of inpatient rehabilitation for older adults soon after dialysis initiation for improving health outcomes\" \/>\n<meta property=\"og:description\" content=\"Rationale and objective \u2014 Multiple studies have shown that older adults\u2019 initiation of dialysis is associated with functional decline often within months\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/effectiveness-of-inpatient-rehabilitation-for-older-adults-soon-after-dialysis-initiation-for-improving-health-outcomes\/\" \/>\n<meta property=\"og:site_name\" content=\"ICES\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/ICESOntario\/\" \/>\n<meta property=\"article:modified_time\" content=\"2025-07-03T20:44:35+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/www.ices.on.ca\/wp-content\/uploads\/2024\/11\/ic-es-data-discovery-better-health-logo.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"1200\" \/>\n\t<meta property=\"og:image:height\" content=\"675\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/publications\\\/journal-articles\\\/effectiveness-of-inpatient-rehabilitation-for-older-adults-soon-after-dialysis-initiation-for-improving-health-outcomes\\\/\",\"url\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/publications\\\/journal-articles\\\/effectiveness-of-inpatient-rehabilitation-for-older-adults-soon-after-dialysis-initiation-for-improving-health-outcomes\\\/\",\"name\":\"ICES | Effectiveness of inpatient rehabilitation for older adults soon after dialysis initiation for improving health outcomes\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/#website\"},\"datePublished\":\"2025-06-30T14:54:35+00:00\",\"dateModified\":\"2025-07-03T20:44:35+00:00\",\"description\":\"Rationale and objective \u2014 Multiple studies have shown that older adults\u2019 initiation of dialysis is associated with functional decline often within months\",\"breadcrumb\":{\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/publications\\\/journal-articles\\\/effectiveness-of-inpatient-rehabilitation-for-older-adults-soon-after-dialysis-initiation-for-improving-health-outcomes\\\/#breadcrumb\"},\"inLanguage\":\"fr-FR\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/publications\\\/journal-articles\\\/effectiveness-of-inpatient-rehabilitation-for-older-adults-soon-after-dialysis-initiation-for-improving-health-outcomes\\\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/publications\\\/journal-articles\\\/effectiveness-of-inpatient-rehabilitation-for-older-adults-soon-after-dialysis-initiation-for-improving-health-outcomes\\\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Journal Articles\",\"item\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/publications\\\/journal-articles\\\/\"},{\"@type\":\"ListItem\",\"position\":3,\"name\":\"Effectiveness of inpatient rehabilitation for older adults soon after dialysis initiation for improving health outcomes\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/#website\",\"url\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/\",\"name\":\"ICES\",\"description\":\"POPULATION-BASED HEALTH RESEARCH THAT MAKES A DIFFERENCE\",\"publisher\":{\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/#organization\"},\"alternateName\":\"Institute for Clinical Evaluative Sciences\",\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"fr-FR\"},{\"@type\":\"Organization\",\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/#organization\",\"name\":\"ICES\",\"alternateName\":\"Institute for Clinical Evaluative Sciences\",\"url\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/\",\"logo\":{\"@type\":\"ImageObject\",\"inLanguage\":\"fr-FR\",\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/#\\\/schema\\\/logo\\\/image\\\/\",\"url\":\"https:\\\/\\\/www.ices.on.ca\\\/wp-content\\\/uploads\\\/2023\\\/04\\\/ices-logo.png\",\"contentUrl\":\"https:\\\/\\\/www.ices.on.ca\\\/wp-content\\\/uploads\\\/2023\\\/04\\\/ices-logo.png\",\"width\":\"676\",\"height\":\"618\",\"caption\":\"ICES\"},\"image\":{\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/#\\\/schema\\\/logo\\\/image\\\/\"},\"sameAs\":[\"https:\\\/\\\/www.facebook.com\\\/ICESOntario\\\/\",\"https:\\\/\\\/www.linkedin.com\\\/company\\\/ices-research-institute\\\/\"]}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"ICES | Effectiveness of inpatient rehabilitation for older adults soon after dialysis initiation for improving health outcomes","description":"Rationale and objective \u2014 Multiple studies have shown that older adults\u2019 initiation of dialysis is associated with functional decline often within months","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/effectiveness-of-inpatient-rehabilitation-for-older-adults-soon-after-dialysis-initiation-for-improving-health-outcomes\/","og_locale":"fr_FR","og_type":"article","og_title":"ICES | Effectiveness of inpatient rehabilitation for older adults soon after dialysis initiation for improving health outcomes","og_description":"Rationale and objective \u2014 Multiple studies have shown that older adults\u2019 initiation of dialysis is associated with functional decline often within months","og_url":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/effectiveness-of-inpatient-rehabilitation-for-older-adults-soon-after-dialysis-initiation-for-improving-health-outcomes\/","og_site_name":"ICES","article_publisher":"https:\/\/www.facebook.com\/ICESOntario\/","article_modified_time":"2025-07-03T20:44:35+00:00","og_image":[{"width":1200,"height":675,"url":"https:\/\/www.ices.on.ca\/wp-content\/uploads\/2024\/11\/ic-es-data-discovery-better-health-logo.jpg","type":"image\/jpeg"}],"twitter_card":"summary_large_image","schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebPage","@id":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/effectiveness-of-inpatient-rehabilitation-for-older-adults-soon-after-dialysis-initiation-for-improving-health-outcomes\/","url":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/effectiveness-of-inpatient-rehabilitation-for-older-adults-soon-after-dialysis-initiation-for-improving-health-outcomes\/","name":"ICES | Effectiveness of inpatient rehabilitation for older adults soon after dialysis initiation for improving health outcomes","isPartOf":{"@id":"https:\/\/www.ices.on.ca\/fr\/#website"},"datePublished":"2025-06-30T14:54:35+00:00","dateModified":"2025-07-03T20:44:35+00:00","description":"Rationale and objective \u2014 Multiple studies have shown that older adults\u2019 initiation of dialysis is associated with functional decline often within months","breadcrumb":{"@id":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/effectiveness-of-inpatient-rehabilitation-for-older-adults-soon-after-dialysis-initiation-for-improving-health-outcomes\/#breadcrumb"},"inLanguage":"fr-FR","potentialAction":[{"@type":"ReadAction","target":["https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/effectiveness-of-inpatient-rehabilitation-for-older-adults-soon-after-dialysis-initiation-for-improving-health-outcomes\/"]}]},{"@type":"BreadcrumbList","@id":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/effectiveness-of-inpatient-rehabilitation-for-older-adults-soon-after-dialysis-initiation-for-improving-health-outcomes\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/www.ices.on.ca\/fr\/"},{"@type":"ListItem","position":2,"name":"Journal Articles","item":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/"},{"@type":"ListItem","position":3,"name":"Effectiveness of inpatient rehabilitation for older adults soon after dialysis initiation for improving health outcomes"}]},{"@type":"WebSite","@id":"https:\/\/www.ices.on.ca\/fr\/#website","url":"https:\/\/www.ices.on.ca\/fr\/","name":"ICES","description":"POPULATION-BASED HEALTH RESEARCH THAT MAKES A DIFFERENCE","publisher":{"@id":"https:\/\/www.ices.on.ca\/fr\/#organization"},"alternateName":"Institute for Clinical Evaluative Sciences","potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/www.ices.on.ca\/fr\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"fr-FR"},{"@type":"Organization","@id":"https:\/\/www.ices.on.ca\/fr\/#organization","name":"ICES","alternateName":"Institute for Clinical Evaluative Sciences","url":"https:\/\/www.ices.on.ca\/fr\/","logo":{"@type":"ImageObject","inLanguage":"fr-FR","@id":"https:\/\/www.ices.on.ca\/fr\/#\/schema\/logo\/image\/","url":"https:\/\/www.ices.on.ca\/wp-content\/uploads\/2023\/04\/ices-logo.png","contentUrl":"https:\/\/www.ices.on.ca\/wp-content\/uploads\/2023\/04\/ices-logo.png","width":"676","height":"618","caption":"ICES"},"image":{"@id":"https:\/\/www.ices.on.ca\/fr\/#\/schema\/logo\/image\/"},"sameAs":["https:\/\/www.facebook.com\/ICESOntario\/","https:\/\/www.linkedin.com\/company\/ices-research-institute\/"]}]}},"_links":{"self":[{"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/journal_article\/22048","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/journal_article"}],"about":[{"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/types\/journal_article"}],"acf:post":[{"embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/research_program\/6743"},{"embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/site\/6739"},{"embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/ices_scientist\/1131"},{"embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/ices_scientist\/1242"},{"embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/ices_scientist\/1208"},{"embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/ices_scientist\/20188"}],"wp:attachment":[{"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/media?parent=22048"}],"wp:term":[{"taxonomy":"migration-helper-automated","embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/migration-helper-automated?post=22048"},{"taxonomy":"migration-manual","embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/migration-manual?post=22048"},{"taxonomy":"topic","embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/topic?post=22048"},{"taxonomy":"migration-helper-qa-sample-set","embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/migration-helper-qa-sample-set?post=22048"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}