Effects of etiology on inpatient rehabilitation outcomes in 65- to 74-year-old patients with incomplete paraplegia from a nontraumatic spinal cord injury
Year, Volume, Issue, Page(s):
2010, vol. 2, issue 6, pp 504-513
Study examined differences in rehabilitation outcomes for older patients with a nontraumatic spinal cord injury (NT-SCI) for 5 etiologic diagnoses: degenerative spinal disease (DSD), malignant spinal tumor, benign spinal tumor, vascular ischemia, and spinal abscess. Data were obtained from a total of 1,780 Medicare beneficiaries (65 to 74 years old) with incomplete paraplegia attributable to NT-SCI who were discharged from 479 inpatient rehabilitation facilities. Length of stay (LOS), discharge Functional Independence Measure (FIM) instrument motor item and subscale scores, and discharge destination were the data analyzed. Results indicated that demographic characteristics varied by etiology group. Mean rehabilitation stays ranged from 13.3 days for DSD to 26.4 days for vascular ischemia. Adjusted data showed stays differed across etiology groups. Adjusted discharge mean self-care and mobility subscores revealed that patients with DSD and benign tumor were more independent than patients with a malignant tumor or spinal abscess. Patients with vascular ischemia were more dependent in mobility than the DSD and benign tumor groups. Etiologic differences in independence in discharge FIM modifiers were present for walking, bladder and bowel management, and bowel accidents/continence, but not bladder accidents. The percent of patients discharged to a community residence ranged from 59.3 to 92.6 percent. Adjusted data showed that significantly larger percentages of patients in the DSD and malignant tumor groups than in the spinal abscess group were discharged to a community residence. The findings indicate that there are etiologic differences in demographics, rehabilitation LOS, functional outcomes, and discharge destination in elderly patients with NT-SCI.
Kay E, Deutsch A, Chen D, Manheim L, Rowles D
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