Conclusions: PEG is a generally safe and useful means to providelong-term enteral nutrition. In acute inpatient rehabilitation, pa-tients frequently are admitted with PEGs and regain their ability toswallow and tolerate food by mouth prior to discharge. RemovingPEG tubes has been a routine responsibility of the rehabilitationphysician. A mature tract forms 7-14 days following PEG place-ment; however, wound healing can be theoretically delayed in thosewho are immunosupressed. Enough time must be given prior toremoving a PEG tube to prevent significant morbidity. Guidelinesrecommending specifically when a PEG can be safely removedshould be implemented.

Poster 342Venous Thromboembolism (VTE) Algorithm:Screening and Treatment Criteria and SpecificsBased Upon Pathophysiology and Data at anUrban Hospital System.Nancey T. Tsai, MD (Medical University of South Caro-lina, Charleston, SC, United States); Douglas McGill,MD; Britt Tonnessen, MD.

Disclosures: N. T. Tsai, Non-remunerative positions of influence:American Council on Exercise.Objective: 1. Review data extracted from one inpatient rehabili-tation facility (IRF) already using screening criteria on all patientsadmitted, 2. Propose an algorithm based upon dialog within theVTE team.Design: Between 2009-2011, all patients were screened routinelyfor VTE and data collected. Rates of VTEs POA and HAC werestratified, risk factors identified, and subsequent symptomatic pul-monary embolus complications were analyzed. A hospital workgroup consisting of representatives from surgical specialties andrehabilitation medicine was created. Treatment algorithms weredeveloped and are currently in place.Setting: Urban inpatient rehabilitation hospital affiliated with anacute-care hospital.Participants: Patients admitted to IRF were screened for VTE anddata collected. Criteria developed by a work group including phy-sicians in several specialties to stratify risk and benefit yield. Screen-ing and treatment algorithms were suggested, allowing for physicianjudgment in cases with additional known risk factors.Interventions: Patients were screened for VTEs, stratified for riskand appropriate prophylactic anticoagulation started for those inthe moderate to high risk groups. A hospital work group provideddirection on prevention of DVTs. Complications from overtreat-ment of superficial and/or other small caliber veins were analyzed,with the final algorithm to reflect routine Doppler study in thighveins only.Main Outcome Measures: DVTs: POA vs HAC for RoperRehabilitation Hospital (RRH) Algorithm formation.Results: 3002 patients screened for VTEs, 156 POA, 47 HACDVTs, 7 patients symptomatic for and were found to have PE. All ofthe patients found to have DVT were treated appropriately, onreview by the work group. No complications occurred due toanticoagulation for DVT during IRF stay.Conclusions: The work group’s current recommendations arefor otherwise asymptomatic patients to be screened for VTE in thethigh veins only with Doppler. Unless contraindicated by history ofbleeding events, patients who are stratified to be at moderate or highrisk for DVTs receive both chemical and mechanical prophylaxis.

Chemical prophylaxis can include low molecular weight heparin(LWMH), unfractionated heparin, Coumadin, and/or aspirin.

Poster 343Rate of Return to Acute Care Hospital Based onDay and Time of Rehabilitation Admission.Natalie Cooper (East Carolina University/Brody Schoolof Medicine, Greenville, NC, United States); MichaelBunch, MD; Clinton E. Faulk, MD; Keith Foster, MD;Enrique Galang, MD; Judit A. Staneata, MD.

Disclosures: N. Cooper, No Disclosures.Objective: To examine if the time or day of admission had animpact on whether inpatients at an inpatient regional rehabilitationcenter (RRC) required a return to an acute care hospital.Design: Retrospective chart review.Setting: Inpatient rehabilitation regional rehabilitation center.Participants: All adult patients admitted to inpatient rehabilita-tion from January 1st, 2009 to June 30th, 2011. Return to AcuteCare Hospital (RTACH) was defined as an interruption in thepatients’ rehabilitation course secondary to medical and/or surgicalcomplications requiring a higher level of care. The control groupwas defined as patients who completed their rehabilitation courseuninterrupted. A total of 2282 patients (2026 control patients and256 case patients) were included in the study.Results: We reviewed patient demographics, admission impair-ment groups, diagnosis discharge, admission and discharge FIMscores, length of stay, and attached hospital versus outside hospitaladmissions were compared between cases and controls. Out of 2282patients admitted to an RRC over a 30-month period, 256 patientsrequired a transfer to the acute care hospital for a higher level of carenot offered in the RRC. There were two statistically significantresults that included: inpatient rehabilitation admissions after 2pmand Functional Independent Measures (admission, total and dis-charge scores). Day of the week for inpatient rehabilitation admis-sion was not found to be statistically significant.Conclusions: This study showed statistically significant resultswith time of inpatient rehabiltation admission. The later a patientwas admitted to the inpatient rehabilitation unit, the higher the rateof RTACH. Further research will be needed to determine the under-lying contributing factors that would help to decrease the rate ofRTACH. A second statistically significant result was lower FIMscores. This correlation with RTACH is yet to be determined andmay be facility-dependent.

Poster 344Reference Values for the Six-Minute Walking Test inObese Subjects.Paolo Capodaglio, MD (Istituto Auxologico Italiano,IRCCS, Oggebbio, Italy); Amelia Brunani, MD; VeronicaCimolin, PhD.

Disclosures: P. Capodaglio, No Disclosures.Objective: The six-minute walking test (6MWT) is widely usedto measure functional capacity in various chronic conditions. Pre-dictive equations have been proposed, but obese subjects consis-tently show a deficit in distance walked when compared to normal-weight subjects. Specific reference values would serve as realisticbenchmark to assess baseline functional capacity and monitorchanges after rehabilitation. The aim of this study was to develop a

S307PM&R Vol. 4, Iss. 10S, 2012