David M Robinson1, Moussa S Bazzi2, Scott R Millis2, Ali A Bitar2. 1. a School of Medicine , Wayne State University , Detroit , Michigan , USA. 2. b Department of Physical Medicine and Rehabilitation , Rehabilitation Institute of Michigan , Detroit , Michigan , USA.
Abstract
OBJECTIVES: To investigate the frequency of and reasons for readmissions to acute care (RTAC) during inpatient rehabilitation (IPR) after non-traumatic spinal cord injury (NT-SCI). To develop a predictive model for RTAC using identified risk factors. DESIGN: Retrospective case-control. SETTING: Academic IPR hospital. PARTICIPANTS: Individuals with NT-SCI admitted to an academic SCI rehabilitation unit from January 2014-December 2015. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Readmissions to acute care services from IPR. RESULTS: Thirty-seven participants (20%) experienced a RTAC for a total of 39 episodes. Thirty-five experienced 1 RTAC, while two had 2. The most common medical reasons for RTAC were infection (27%), neurological (27%), and noninfectious respiratory (16%). Multivariable logistic regression was used to develop a model to predict RTAC. Paraplegia was associated with 3.2 times increase in the odds of RTAC (P = 0.03). For every unit increase in FIM-Motor, there was a 5% reduction in the odds of RTAC (P = 0.03) Body mass index less than 30 decreased odds of RTAC by 61% (P = 0.004). CONCLUSION: RTACs were associated with body mass index greater than 30, decreased FIM-Motor subscore on admission, and paraplegia. Physiatrists caring for the non-traumatic SCI patient need be more circumspect of individuals with these parameters to potentially prevent the problems necessitating acute care transfer.
OBJECTIVES: To investigate the frequency of and reasons for readmissions to acute care (RTAC) during inpatient rehabilitation (IPR) after non-traumatic spinal cord injury (NT-SCI). To develop a predictive model for RTAC using identified risk factors. DESIGN: Retrospective case-control. SETTING: Academic IPR hospital. PARTICIPANTS: Individuals with NT-SCI admitted to an academic SCI rehabilitation unit from January 2014-December 2015. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Readmissions to acute care services from IPR. RESULTS: Thirty-seven participants (20%) experienced a RTAC for a total of 39 episodes. Thirty-five experienced 1 RTAC, while two had 2. The most common medical reasons for RTAC were infection (27%), neurological (27%), and noninfectious respiratory (16%). Multivariable logistic regression was used to develop a model to predict RTAC. Paraplegia was associated with 3.2 times increase in the odds of RTAC (P = 0.03). For every unit increase in FIM-Motor, there was a 5% reduction in the odds of RTAC (P = 0.03) Body mass index less than 30 decreased odds of RTAC by 61% (P = 0.004). CONCLUSION: RTACs were associated with body mass index greater than 30, decreased FIM-Motor subscore on admission, and paraplegia. Physiatrists caring for the non-traumatic SCIpatient need be more circumspect of individuals with these parameters to potentially prevent the problems necessitating acute care transfer.
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