TY - JOUR
T1 - Rehabilitation length of stay and functional improvement among patients with traumatic spinal cord injury
AU - Kao, Yu Hsiang
AU - Chen, Yuying
AU - Deutsch, Anne
AU - Wen, Huacong
AU - Tseng, Tung Sung
N1 - Funding Information:
This research was supported by the School of Public Health, Louisiana State University Health Sciences Center-New Orleans, the National Spinal Cord Injury Statistical Center (NIDILRR 90DP0083), the Midwest Regional Spinal Cord Injury Model System (NIDILRR 90SI5022) and University of Alabama at Birmingham.
Funding Information:
This research was supported by the School of Public Health, Louisiana State University Health Sciences Center-New Orleans, the National Spinal Cord Injury Statistical Center (NIDILRR 90DP0083), University of Alabama at Birmingham, the Midwest Regional Spinal Cord Injury Model System 90SI5022 and the Postdoctoral Research Abroad Program (MOST 106-2917-I-564-039) from the Ministry of Science and Technology of the Republic of China (Taiwan).
Publisher Copyright:
© 2021, The Author(s), under exclusive licence to International Spinal Cord Society.
PY - 2022/3
Y1 - 2022/3
N2 - Study Design:: Retrospective cohort study. Objective: Investigate the association between rehabilitation length of stay (LOS) and motor FIM® (mFIM) between rehabilitation admission and discharge among patients with traumatic spinal cord injury (SCI). Setting: Seventeen SCI Model Systems (SCIMS) centers in the United States. Methods: A total of 3386 patients with traumatic SCI enrolled in the SCIMS Database from 2011 to 2018. The main outcome measure was the mean change in mFIM (12 items) between rehabilitation admission and discharge by twelve neurological categories (C1-C4 American Spinal Injury Association impairment scale (AIS) A-B, AIS C, AIS D, and C5-C8 AIS A-B, AIS C, AIS D, and T1-T10 AIS A-B, AIS C, AIS D, and T11-S3 AIS A-B, C, D). Linear regression models were applied to estimate changes across rehabilitation LOS groups (shortest LOS, quarter2, quarter3, and longest LOS) after adjusting for covariables for each neurological category. Results: The mean age of study patients was 44.5 years. Patients were predominantly men (78.5%), non-Hispanic white (64.8%), and had private insurance (57.1%). The median LOS was 42 days across the entire sample. Longer LOS was associated with a higher mFIM score compared to the shortest LOS among patients with C1–C4 AIS D; C5-C8 AIS D; T1–T10 AIS A–B; and T11-S3 AIS A–B, C, and D after adjusting for demographics and clinical characteristics. Conclusion: Among patients with C1–C4 AIS D; C5–C8 AIS D; T1–T10 AIS A–B; and T11-S3 AIS A–B, C, and D injuries, those with longer rehabilitation stays tended to have more motor function improvement.
AB - Study Design:: Retrospective cohort study. Objective: Investigate the association between rehabilitation length of stay (LOS) and motor FIM® (mFIM) between rehabilitation admission and discharge among patients with traumatic spinal cord injury (SCI). Setting: Seventeen SCI Model Systems (SCIMS) centers in the United States. Methods: A total of 3386 patients with traumatic SCI enrolled in the SCIMS Database from 2011 to 2018. The main outcome measure was the mean change in mFIM (12 items) between rehabilitation admission and discharge by twelve neurological categories (C1-C4 American Spinal Injury Association impairment scale (AIS) A-B, AIS C, AIS D, and C5-C8 AIS A-B, AIS C, AIS D, and T1-T10 AIS A-B, AIS C, AIS D, and T11-S3 AIS A-B, C, D). Linear regression models were applied to estimate changes across rehabilitation LOS groups (shortest LOS, quarter2, quarter3, and longest LOS) after adjusting for covariables for each neurological category. Results: The mean age of study patients was 44.5 years. Patients were predominantly men (78.5%), non-Hispanic white (64.8%), and had private insurance (57.1%). The median LOS was 42 days across the entire sample. Longer LOS was associated with a higher mFIM score compared to the shortest LOS among patients with C1–C4 AIS D; C5-C8 AIS D; T1–T10 AIS A–B; and T11-S3 AIS A–B, C, and D after adjusting for demographics and clinical characteristics. Conclusion: Among patients with C1–C4 AIS D; C5–C8 AIS D; T1–T10 AIS A–B; and T11-S3 AIS A–B, C, and D injuries, those with longer rehabilitation stays tended to have more motor function improvement.
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U2 - 10.1038/s41393-021-00686-6
DO - 10.1038/s41393-021-00686-6
M3 - Article
C2 - 34389812
AN - SCOPUS:85112705492
SN - 1362-4393
VL - 60
SP - 237
EP - 244
JO - Spinal Cord
JF - Spinal Cord
IS - 3
ER -