TY - JOUR
T1 - Racial and ethnic disparities in functioning at discharge and follow-up among patients with motor complete spinal cord injury
AU - Fyffe, Denise C.
AU - Deutsch, Anne
AU - Botticello, Amanda L.
AU - Kirshblum, Steven
AU - Ottenbacher, Kenneth J.
N1 - Funding Information:
Secondary data analyses were conducted using data extracted from the SCIMS database (sponsored by the U.S. Department of Education's National Institute on Disability and Rehabilitation Research). The SCIMS database is a longitudinal repository of clinical, psychosocial, health, and functional data on patients with traumatic SCI. 36 In-depth descriptions of the SCIMS database history and methods are described elsewhere. 4,36-38 Each center has approval by its local institutional review board, and the primary site for the current study obtained approval from the institutional review board to conduct the current analysis.
Publisher Copyright:
© 2014 American Congress of Rehabilitation Medicin.
Copyright:
Copyright 2015 Elsevier B.V., All rights reserved.
PY - 2014/11/1
Y1 - 2014/11/1
N2 - Objective To examine racial and ethnic differences in self-care and mobility outcomes for persons with a motor complete, traumatic spinal cord injury (SCI) at discharge and 1-year follow-up.Design Retrospective cohort study.Setting Sixteen rehabilitation centers contributing to the Spinal Cord Injury Model Systems (SCIMS) database.Participantsg Adults with traumatic, motor complete SCI (N=1766; American Spinal Injury Association Impairment Scale grade A or B) enrolled in the SCIMS between 2000 and 2011. Selected cases had complete self-reported data on race and ethnicity (non-Hispanic white, non-Hispanic black, or Hispanic) and motor FIM scores assessed at inpatient rehabilitation admission, discharge, and 1-year follow-up.Interventions Not applicable.Main Outcome Measures Functional outcomes were measured by FIM self-care and mobility scores on a 1 to 7 FIM scale, at discharge and 1-year follow-up.Results Multiple regression models stratified by neurologic category and adjusted for sociodemographic and injury characteristics assessed racial and ethnic group differences in FIM self-care and mobility change scores at discharge and 1-year follow-up. At discharge, non-Hispanic black participants with tetraplegia and paraplegia had significantly poorer gains in FIM self-care and mobility scores relative to non-Hispanic white and Hispanic participants. At 1-year follow-up, similar FIM self-care and mobility change scores were found across racial and ethnic groups within each neurologic category.Conclusions Non-Hispanic white and Hispanic participants had comparatively more improvement in self-care and mobility during inpatient rehabilitation compared with non-Hispanic black participants. At 1-year follow-up, no differences in self-care and mobility outcomes were observed across racial and ethnic groups. Additional research is needed to identify potential modifiable factors that may contribute to racially and ethnically different patterns of functional outcomes observed during inpatient rehabilitation.
AB - Objective To examine racial and ethnic differences in self-care and mobility outcomes for persons with a motor complete, traumatic spinal cord injury (SCI) at discharge and 1-year follow-up.Design Retrospective cohort study.Setting Sixteen rehabilitation centers contributing to the Spinal Cord Injury Model Systems (SCIMS) database.Participantsg Adults with traumatic, motor complete SCI (N=1766; American Spinal Injury Association Impairment Scale grade A or B) enrolled in the SCIMS between 2000 and 2011. Selected cases had complete self-reported data on race and ethnicity (non-Hispanic white, non-Hispanic black, or Hispanic) and motor FIM scores assessed at inpatient rehabilitation admission, discharge, and 1-year follow-up.Interventions Not applicable.Main Outcome Measures Functional outcomes were measured by FIM self-care and mobility scores on a 1 to 7 FIM scale, at discharge and 1-year follow-up.Results Multiple regression models stratified by neurologic category and adjusted for sociodemographic and injury characteristics assessed racial and ethnic group differences in FIM self-care and mobility change scores at discharge and 1-year follow-up. At discharge, non-Hispanic black participants with tetraplegia and paraplegia had significantly poorer gains in FIM self-care and mobility scores relative to non-Hispanic white and Hispanic participants. At 1-year follow-up, similar FIM self-care and mobility change scores were found across racial and ethnic groups within each neurologic category.Conclusions Non-Hispanic white and Hispanic participants had comparatively more improvement in self-care and mobility during inpatient rehabilitation compared with non-Hispanic black participants. At 1-year follow-up, no differences in self-care and mobility outcomes were observed across racial and ethnic groups. Additional research is needed to identify potential modifiable factors that may contribute to racially and ethnically different patterns of functional outcomes observed during inpatient rehabilitation.
KW - Activities of daily living
KW - Health status disparities
KW - Motor activity
KW - Rehabilitation
KW - Spinal cord injuries
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U2 - 10.1016/j.apmr.2014.07.398
DO - 10.1016/j.apmr.2014.07.398
M3 - Article
C2 - 25093999
AN - SCOPUS:84908291226
VL - 95
SP - 2140
EP - 2151
JO - Archives of Physical Medicine and Rehabilitation
JF - Archives of Physical Medicine and Rehabilitation
SN - 0003-9993
IS - 11
ER -