Kurt R Herzer1, Yuying Chen2, Allen W Heinemann3, Marlis González-Fernández4. 1. Medical Scientist Training Program, Johns Hopkins School of Medicine, Baltimore, MD. Electronic address: kherzer@jhmi.edu. 2. Department of Physical Medicine and Rehabilitation, University of Alabama at Birmingham, Birmingham, AL. 3. Center for Rehabilitation Outcomes Research, Rehabilitation Institute of Chicago, Chicago, IL; Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, IL. 4. Department of Physical Medicine and Rehabilitation, Johns Hopkins School of Medicine, Baltimore, MD.
Abstract
OBJECTIVE: To examine the relations between time to rehabilitation after spinal cord injury (SCI) and rehabilitation outcomes at discharge and 1-year postinjury. DESIGN: Retrospective cohort study. SETTING: Facilities designated as Spinal Cord Injury Model Systems. PARTICIPANTS: Patients (N=3937) experiencing traumatic SCI between 2000 and 2014, who were 18 years or older, and who were admitted to a model system within 24 hours of injury. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Rasch-transformed FIM motor score at discharge and 1-year postinjury, discharge to a private residence, and the Craig Handicap Assessment and Reporting Technique (CHART) Physical Independence and Mobility scores at 1-year postinjury. RESULTS: After accounting for health status, a 10% increase in time to rehabilitation was associated with a 1.50 lower FIM motor score at discharge (95% confidence interval [CI], -2.43 to -0.58; P=.001) and a 3.92 lower CHART Physical Independence score at 1-year postinjury (95% CI, -7.66 to -0.19; P=.04). Compared to the mean FIM motor score (37.5) and mean CHART Physical Independence score (74.7), the above-mentioned values represent relative declines of 4.0% and 5.3%, respectively. There was no association between time to rehabilitation and discharge to a private residence, 1-year FIM motor score, or the CHART mobility score. CONCLUSIONS: Earlier rehabilitation after traumatic SCI may improve patients' functional status at discharge.
OBJECTIVE: To examine the relations between time to rehabilitation after spinal cord injury (SCI) and rehabilitation outcomes at discharge and 1-year postinjury. DESIGN: Retrospective cohort study. SETTING: Facilities designated as Spinal Cord Injury Model Systems. PARTICIPANTS: Patients (N=3937) experiencing traumatic SCI between 2000 and 2014, who were 18 years or older, and who were admitted to a model system within 24 hours of injury. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Rasch-transformed FIM motor score at discharge and 1-year postinjury, discharge to a private residence, and the Craig Handicap Assessment and Reporting Technique (CHART) Physical Independence and Mobility scores at 1-year postinjury. RESULTS: After accounting for health status, a 10% increase in time to rehabilitation was associated with a 1.50 lower FIM motor score at discharge (95% confidence interval [CI], -2.43 to -0.58; P=.001) and a 3.92 lower CHART Physical Independence score at 1-year postinjury (95% CI, -7.66 to -0.19; P=.04). Compared to the mean FIM motor score (37.5) and mean CHART Physical Independence score (74.7), the above-mentioned values represent relative declines of 4.0% and 5.3%, respectively. There was no association between time to rehabilitation and discharge to a private residence, 1-year FIM motor score, or the CHART mobility score. CONCLUSIONS: Earlier rehabilitation after traumatic SCI may improve patients' functional status at discharge.
Authors: Hannah Wong; Robert C Wu; George Tomlinson; Michael Caesar; Howard Abrams; Michael W Carter; Dante Morra Journal: J Public Health (Oxf) Date: 2009-05-22 Impact factor: 2.341
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