Effects of gender on inpatient rehabilitation outcomes in the elderly with incomplete paraplegia from nontraumatic spinal cord injury

Objective: To examine gender differences in rehabilitation outcomes for patients with nontraumatic spinal cord injury. Research Design: Secondary analysis was conducted on Medicare beneficiary data from 65 to 74 year olds with incomplete paraplegia discharged from inpatient rehabilitation facilities in 2002 through 2005. Main Outcome Measures: Length of stay, Functional Independence Measure instrument motor item and subscale scores on discharge, and discharge destination. Results: Among patients with degenerative spinal disease, men had significantly longer rehabilitation stays than women (P < 0.001). Men with degenerative spinal disease had significantly lower discharge Functional Independence Measure scores than women, indicating more dependence in self-care (P < 0.001) and mobility (P < 0.001). Among patients with degenerative spinal disease, men were less likely to walk (odds ratio = 0.58; 95% CI = 0.38-0.87) and less likely to be independent with bladder management (odds ratio = 0.44; 95% CI = 0.31-0.62). Among patients with vascular ischemia, men were more independent (B = 2.59; 99% CI = 0.42-4.76) in mobility than women. There were no gender differences in the malignant spinal tumors group. There were no gender differences in being discharged to a community-based residence. Conclusions: Gender distributions varied by etiology. Gender differences were found in demographics, length of stay, and functional outcomes but not discharge destination. Men were more dependent than women at discharge in the etiology group with the least overall disability (degenerative spinal disease) and more independent in mobility than women at discharge in the etiology group with the most overall disability (vascular ischemia).