About

Dr. Alexandra Flis is an Associate Professor in the Department of Physical Medicine & Rehabilitation at the University of Utah. She is also the Medical Director of the Craig H. Neilsen Rehabilitation Hospital. She is board certified in Brain Injury Medicine and specializes in early mobility, ICU rehabilitation, and neurorehabilitation. Dr. Flis earned her undergraduate degree in Exercise Science from Colorado State University and completed her medical degree at Drexel University College of Medicine in Philadelphia. She completed her internship and residency in Physical Medicine and Rehabilitation at the University of Utah, where she joined the faculty in 2015 as the Inpatient PM&R Consult Director. In addition to her clinical expertise, Dr. Flis is a dedicated educator, teaching clinical skills as part of the Doctoring Faculty at the University of Utah School of Medicine. She serves as Vice Chair of Clinical Operations for Rehabilitation Medicine, Inpatient Chief Value Officer, and President of the University of Utah Medical Board. With extensive experience in rehabilitation medicine, she is committed to advancing patient care, education, and clinical leadership in neurorehabilitation.

Research topics

• Medicine
• Clinical psychology
• Psychology
• Psychiatry
• Biology
• Nursing
• Immunology
• Psychotherapist
• Virology
• Internal medicine

Selected publications

• Postacute Ventilator Weaning and Discharge Outcomes in Individuals With Cervical Spinal Cord Injury: A Retrospective Analysis

  Respiratory Care · 2026-03-13 · 1 citations

  articleOpen access

  BACKGROUND: Cervical spinal cord injury (CSCI) often results in respiratory muscle weakness, requiring prolonged mechanical ventilation and tracheostomy. However, the frequency and timing of ventilator-weaning milestones after acute hospitalization are not well described. This study assessed the rates and timing of daytime ventilator weaning, liberation from invasive ventilator support, and decannulation among adults with CSCI managed under a standardized weaning protocol at a rehabilitation center, and the associations of weaning milestones with discharge disposition. METHODS: We retrospectively analyzed data from adults with CSCI admitted to the University of Utah Craig H. Neilsen Rehabilitation Hospital between 2015 and 2022. All subjects required continuous mechanical ventilation via tracheostomy upon admission and underwent a standardized ventilator weaning protocol. We tracked the time to reach key ventilator-weaning milestones-daytime wean, liberation from invasive mechanical ventilation, and decannulation-and categorized discharge destinations based on required respiratory support intensity. Predictors of milestone achievement and discharge outcomes were assessed using Fine-Gray competing-risk and proportional odds logistic regression models. RESULTS: Among 39 subjects, 76% were weaned from daytime ventilator support (median day 20), 62% were liberated from invasive ventilatory support (median day 23), and 48% were decannulated (median day 36) by discharge. Subjects with lower-level injuries (C5-C8) were more likely to achieve further weaning and decannulation compared with those with high-level injuries (C1-C4) (odds ratio [OR] 5.54 [1.51-20.38]). Increasing age was associated with discharge to more intensive care settings (OR 0.68 per decade [0.48-0.95]). Decannulated subjects had higher odds of being discharged home (OR 22.84 [2.84-183.57]). No significant differences in weaning status based on discharge disposition were observed. CONCLUSIONS: Most subjects with CSCI initially on continuous mechanical ventilation achieved partial or full ventilatory independence during rehabilitation, although these milestones were often reached several weeks into their stay.

  PublisherDOI

• JUST KEEP TRYING: PRIOR ATTEMPTS AT WEANING DO NOT DETERMINE EVENTUAL LIBERATION FROM TRACHESOTOMY AND MECHANICAL VENTILATION IN HIGH-LEVEL SPINAL CORD PATIENTS

  CHEST Journal · 2023-10-01

  article
  PublisherDOI

• The human anti-ganglioside GM1 autoantibody response following traumatic and surgical central nervous system insults

  Neuroscience Research · 2022 · 4 citations

  • Medicine
  • Immunology
  • Internal medicine
  PublisherDOI

• 487 The Human Anti-Ganglioside GM1 Autoantibody Response Following Traumatic and Surgical Central Nervous System Insults

  Neurosurgery · 2022-03-01

  article

  INTRODUCTION: The immune response to central nervous system (CNS) injuries has long been considered a significant contributor to secondary injury following neurotrauma however the autoimmune response to the normal immune-privileged CNS has been insufficiently considered. It has been identified as a possible pathomechanism underlying delayed dementias known to occur after TBI and SCI however the CNS-directed autoantibody response following CNS injury remains poorly understood and the autoimmune response following intra-axial brain surgery is unknown. METHODS: Nine serum samples were collected serially from 17 acute severe TBI, 22 acute SCI, and 24 intra-axial brain tumor resection patients for 30 days; 25 healthy subjects served as a control group. An ELISA assay quantitated IgG and IgM autoantibodies to ganglioside GM-1. The maximum autoantibody titers and their correlation with putative predictors such as age, gender, clinical and radiological measurements were investigated. RESULTS: Anti-GM1 IgG autoantibody titers were increased following SCI, TBI, and brain tumor resection as compared with baseline values and control patients. By contrast, anti-GM1 IgM autoantibody titers did not significantly change following insult nor show promise as a biomarker. The maximum IgG titers measured in the first 30 days were significantly increased in TBI patients (p<0.01), in SCI patients (p<0.01), and in brain tumor resection patients (p<0.05). The highest IgG titers (or peaks) were most commonly seen at day 14 post-insult in TBI and SCI patients while brain tumor patients did not demonstrate acute increases consistent with a peak. Higher GM1 IgG autoantibodies were associated with more severe insults. The Rotterdam score strongly correlated with increased IgG titers in TBI patients (p<0.05). Age and gender did not correlate with GM1 autoantibody titers in any of the types of insult we studied. CONCLUSION: These findings suggest that patients with diverse CNS insults are at risk for CNS-directed autoimmune responses and in particular those with more severe insults. These findings highlight the need to better understand the CNS-directed autoimmune response to insult, its clinical relevance and potential as a therapeutic target.

  PublisherDOI

• “We’re Not Meant to Deal with Crisis for a Year”: Supporting Frontline Healthcare Providers’ Wellness During a Pandemic

  Pervasive Computing Technologies for Healthcare · 2022 · 4 citations

  • Nursing
  • Psychology
  • Medicine
  PublisherDOI

• Work coping, stress appraisal, and psychological resilience: Reaction to the COVID-19 pandemic among health care providers.

  Psychology & Neuroscience · 2021 · 22 citations

  • Psychology
  • Clinical psychology
  • Psychiatry

  Objective: This study examined the relationship between perceived stress appraisals and coping style during the COVID-19 pandemic, resulting distress reaction and effects on work engagement. Method: The sample (N = 423) was 78.6% female with average age and education of 38.5 and 18.4 years, respectively. Most respondents reported working in psychology/neuropsychology (31.7%) and rehabilitation/other therapies (29.7%). Surveys were distributed via Qualtrics among health care providers via listservs and referral emails from medical providers. Measures included: the Brief COPE Inventory, Work and Well Being Survey (UWES), Stress Appraisal Measure (SAM), Generalized Anxiety Disorder Screener (GAD-7), and the Screening Tool for Psychological Distress (STOP-D). Results: Health care workers endorsing problem-focused coping styles had lower levels of perceived threat and higher levels of perceived control in their response to the pandemic. Problem-focused coping was negatively associated with anxiety and depression in reaction to the pandemic when compared with health care workers who endorsed an emotion-focused coping style. Higher stress appraisal in response to perceived threat from the pandemic was not associated with lower work engagement or enthusiasm. Conclusions: Findings support the impact of coping style on psychological distress and work engagement during pandemic, with implications that these factors may be important considerations for mitigation of distress and burnout for health care workers during times of high stress. Initiatives to improve resiliency and wellness in health care workers may examine modifiable interventions for coping style. (PsycInfo Database Record (c) 2021 APA, all rights reserved) Impact Statement This study suggests that, among health care workers, using a problem focused coping style in response to COVID-19 pandemic stress mitigates experience of psychological distress and burnout. Initiatives that focus on modifiable interventions for coping styles may improve wellness in health care workers during environments of high stress, such as a chronic pandemic state. (PsycInfo Database Record (c) 2021 APA, all rights reserved)

  PublisherDOI

• Cost Analysis of Inpatient Rehabilitation after Spinal Injury: A Retrospective Cohort Analysis

  Cureus · 2019-09-24 · 10 citations

  articleOpen access

  Objective The lifetime direct and indirect costs of spinal injury and spinal cord injury (SCI) increase as the severity of injury worsens. Despite the potential for substantial improvement in function with acute rehabilitation, the factors affecting its cost have not yet been evaluated. We used a proprietary hospital database to evaluate the direct costs of rehabilitation after spine injury. Methods A single-center, retrospective cohort cost analysis of patients with acute, traumatic spine injury treated at a tertiary facility from 2011 to 2017 was performed. Results In the 190 patients (mean age 46.1 ± 18.6 years, 76.3% males) identified, American Spinal Injury Association impairment scores on admission were 32.1% A, 14.7% B, 14.7% C, 33.2% D, and 1.1% E. Surgical treatment was performed in 179 (94.2%) cases. Most injuries were in the cervical spine (53.2%). A mean improvement of Functional Impairment Score of 30.7 ± 16.2 was seen after acute rehabilitation. Costs for care comprised facility (86.5%), pharmacy (9.2%), supplies (2.0%), laboratory (1.5%), and imaging (0.8%) categories. Injury level, injury severity, and prior inpatient surgical treatment did not affect the cost of rehabilitation. Higher injury severity (p = 0.0001, one-way ANOVA) and spinal level of injury (p = 0.001, one-way ANOVA) were associated with higher length of rehabilitation stay in univariate analysis. However, length of rehabilitation stay was the strongest independent predictor of higher-than-median cost (risk ratio = 1.56, 95% CI 1.21-2.0, p = 0.001) after adjusting for other factors. Conclusions Spine injury has a high upfront cost of care, with greater need for rehabilitation substantially affecting cost. Improving the efficacy of rehabilitation to reduce length of stay may be effective in reducing cost.

  PublisherOA PDFDOI

• The Effect of Hospital Transfer on Patient Outcomes After Rehabilitation for Spinal Injury

  World Neurosurgery · 2019-09-12 · 16 citations

  article
  PublisherDOI

• Self-Reported Use and Attitudes Toward Performance-Enhancing Drugs in Ultramarathon Running

  Wilderness and Environmental Medicine · 2018-06-29 · 17 citations

  article

  INTRODUCTION: The use of performance enhancing drugs (PEDs) has been reported in several sports. There have been no peer-reviewed articles on the use of PEDs in ultramarathon running. This study was to examine the use of PEDs in ultramarathon running and to identify attitudes and beliefs about the usage of PEDs in the sport. METHODS: An online survey was developed. The survey was distributed to potential participants through Ultrasignup and the Western States Endurance Run Facebook sites. The survey included 9 demographic questions, 11 PED questions, and a previously validated 17-item performance enhancement attitude scale (PEAS). RESULTS: Six hundred nine self-identified ultramarathon runners completed the survey; 8.4% of respondents reported using PEDs during competition or training. Cannabinoids, narcotics, and stimulants were the PEDs that were most frequently reported. There was no difference between sex, age, country of origin, rank, miles/week of training, or longest race between those that reported using PEDs and those that did not report using PEDs. There was, however, a significant difference in athletes who reported they knew another ultramarathon runner who had used PEDs to have significantly higher years of participation and ranked in the top 20th percentile. There additionally was an increased PEAS score of individuals who reported using a PED or individuals that knew an individual who used PEDs. CONCLUSION: PEDs are being used in ultramarathon running. The exact extent of the use of PEDs in ultramarathon running is still unknown and challenging to fully investigate without formal, random testing, which is expensive and technically challenging.

  PublisherDOI

• Poster 485: Self‐Reported Use and Attitudes Toward Performance Enhancing Drugs in Ultramarathon Running

  PM&R · 2017-09-01

  article
  PublisherDOI

Frequent coauthors

• Jeffrey Rosenbluth

  5 shared

• Daniel M. Cushman

  University of Utah

  4 shared

• Christopher E. Pelt

  University of Utah

  4 shared

• Andrés M. Rubiano

  Universidad El Bosque

  3 shared

• Gregory W. J. Hawryluk

  Akron General Medical Center

  3 shared

• Stuart E. Willick

  University of Utah

  3 shared

• Zachary L. McCormick

  University of Utah

  3 shared

• Ethan C. Reichert

  University of Utah

  3 shared

Labs

• University of Utah Health - Department of Physical Medicine & RehabilitationPI

Education

• B.S., Exercise Science

  Colorado State University

• M.D.

  Drexel University College of Medicine

• Other, Physical Medicine and Rehabilitation

  University of Utah

Awards & honors

• American Board of Physical Medicine & Rehabilitation (Sub: B…