{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T22:13:27Z","timestamp":1785795207560,"version":"3.56.0"},"reference-count":18,"publisher":"Public Library of Science (PLoS)","issue":"5","license":[{"start":{"date-parts":[[2023,5,25]],"date-time":"2023-05-25T00:00:00Z","timestamp":1684972800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Guillain-Barre-Syndrome (GBS), an autoimmune polyneuropathy causing acute flaccid paralysis, is a rare condition with1-2 cases per 100,000 annually (approximately 5000 cases\/year) in the United States (US). There is a paucity of published data regarding patient outcomes in association with discharge destinations following inpatient-rehabilitation (IR) in this patient population, thus this study.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Objectives<\/jats:title>\n<jats:p>To analyze IR efficacy, and possible predictors of discharge to home\/community in a US-national-sample of GBS patients.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Methods<\/jats:title>\n<jats:p>Retrospective-observational-cohort study of 1304 GBS patients admitted to IR comparing discharge disposition destinations (community\/home, skilled-nursing-facility [SNF], or return to acute-care) by demographic (age, gender) and clinical variables (length-of-stay [LOS], case-mix-index [CMI], and Functional-Independence-Measure [FIM] score changes). Multinomial-logistic-regression and discriminant-function-analysis were performed to determine model fit in predicting discharge destination.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Results<\/jats:title>\n<jats:p>81.8% were discharged to home\/community- average LOS 19-days, total-FIM-gain 43.2; 9.8% discharged to SNFs- average LOS 27.5-days, total-FIM-gain 27.2; and 8.4% discharged to acute-care- average LOS 15.4-days and total-FIM-gain 16.5, (F = 176, p &lt; .001). Stepwise-linear-regression for prediction of community discharge showed change in FIM-Bed\/chair\/wheelchair-Transfers was the most significant predictor (Wald = 42.2; p &lt; .001), followed by CMI (Wald = 26.9; p &lt; .001), change in FIM-walking\/wheelchair (Wald = 14.9; p &lt; .001), and age (Wald = 9.5; p &lt; .002). Using discriminant-function-analysis to test model validity for predicting discharge disposition, FIM-change for Bed\/chair\/wheelchair Transfers, Walking, and Self-Care as predictors resulted in a classification rate of 78.1%, 92% of variance explained, and Eigenvalue of .53 (p &lt; .001).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec005\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Total-FIM scores improved in all groups, and most patients were discharged to home\/community suggesting IR efficacy. The ability to transfer bed\/chair\/wheelchair was the most important predictive factor associated with discharge destination.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0286296","type":"journal-article","created":{"date-parts":[[2023,5,25]],"date-time":"2023-05-25T17:30:41Z","timestamp":1685035841000},"page":"e0286296","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":3,"title":["Predictors of discharge to home\/community following inpatient-rehabilitation in a US national sample of Guillain-Barre-Syndrome patients"],"prefix":"10.1371","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6090-6304","authenticated-orcid":true,"given":"David S.","family":"Kushner","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Doug","family":"Johnson-Greene","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth R.","family":"Felix","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheryl","family":"Miller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maite K.","family":"Cordero","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stacy A.","family":"Thomashaw","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2023,5,25]]},"reference":[{"issue":"5","key":"pone.0286296.ref001","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1093\/qjmed\/hcv190","article-title":"Outcome of Guillain-Barre syndrome patients with respiratory paralysis","volume":"109","author":"J Kalita","year":"2016","journal-title":"QJM"},{"issue":"8","key":"pone.0286296.ref002","doi-asserted-by":"crossref","first-page":"872","DOI":"10.1016\/S0003-9993(97)90203-3","article-title":"Rehabilitation of Guillain-Barr\u00e9 syndrome","volume":"78","author":"JM Meythaler","year":"1997","journal-title":"Arch Phys Med Rehabil"},{"issue":"11","key":"pone.0286296.ref003","doi-asserted-by":"crossref","first-page":"671","DOI":"10.1038\/s41582-019-0250-9","article-title":"Diagnosis and management of Guillain\u2013Barr\u00e9 syndrome in ten steps.","volume":"15","author":"SE Leonhard","year":"2019","journal-title":"Nat Rev Neurol. 2019"},{"key":"pone.0286296.ref004","article-title":"Guillain-Barr\u00e9 syndrome: clinical profile and management.","author":"SR Sudulagunta","year":"2015","journal-title":"Ger Med Sci"},{"issue":"3","key":"pone.0286296.ref005","first-page":"507","article-title":"Rehabilitation interventions in patients with acute demyelinating inflammatory polyneuropathy: a systematic review","volume":"48","author":"F Khan","year":"2012","journal-title":"Eur J Phys Rehabil Med"},{"issue":"10","key":"pone.0286296.ref006","doi-asserted-by":"crossref","first-page":"954","DOI":"10.1097\/PHM.0000000000001944","article-title":"Ability realization improves during inpatient rehabilitation for Guillain-Barr\u00e9 syndrome","volume":"101","author":"M Shniper","year":"2022","journal-title":"Am J Phys Med Rehabil"},{"issue":"12","key":"pone.0286296.ref007","doi-asserted-by":"crossref","first-page":"879","DOI":"10.1097\/PHM.0000000000000991","article-title":"Improvement During Inpatient Rehabilitation Among Older Adults with Guillain-Barr\u00e9 Syndrome, Multiple Sclerosis, Parkinson Disease, and Stroke","volume":"97","author":"AW Andrews","year":"2018","journal-title":"Am J Phys Med Rehabil"},{"issue":"5","key":"pone.0286296.ref008","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1097\/WNP.0000000000000380","article-title":"Guillain-Barr\u00e9 Syndrome and Swallowing Dysfunction.","volume":"34","author":"T Mengi","year":"2017","journal-title":"J Clin Neurophysiol."},{"issue":"2","key":"pone.0286296.ref009","doi-asserted-by":"crossref","first-page":"e0143837","DOI":"10.1371\/journal.pone.0143837","article-title":"Hospital Admissions, Transfers and Costs of Guillain-Barr\u00e9 Syndrome.","volume":"11","author":"N van Leeuwen","year":"2016","journal-title":"PloS One."},{"issue":"8","key":"pone.0286296.ref010","doi-asserted-by":"crossref","first-page":"961","DOI":"10.1080\/02699052.2018.1476734","article-title":"Introduction to TBI Model Systems 2012\u20132017 special section","volume":"32","author":"T. 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