Citation

Krause JS, Cao Y, Bozard JL. Arch. Phys. Med. Rehabil. 2013; 94(1): 32-37.

Affiliation

Department of Health Sciences and Research, College of Health Professions, Medical University of South Carolina, Charleston, SC.

Copyright

(Copyright © 2013, Elsevier Publishing)

DOI

10.1016/j.apmr.2012.08.203

PMID

22922329

Abstract

OBJECTIVE: To identify changes in hospitalizations, days hospitalized, non-routine physician visits, and self-reported fitness over 4 measurements separated by 4-5 year intervals among participants with spinal cord injury (SCI), while testing for the effects of age, time since injury, and age at injury onset. DESIGN: A mixed model was used to analyze the cross sequential data that includes cross-sectional and longitudinal elements. The data were collected in 1993, 1998, 2003, and 2008. SETTING: Data were collected at 2 Midwestern hospitals and a Southeastern specialty hospital in the United States. PARTICIPANTS: There were 1032 adult participants with SCI of at least 1 year duration who participated during at least one of 4 times of measurement dating back to 1993. Of these, 463 participated on all 4 occasions. INTERVENTIONS: None. MAIN OUTCOME MEASURES: The outcome measures were 3 indicators of medical treatments including hospitalization, days hospitalized, and non-routine physician visits. A fourth outcome was self-reported fitness. RESULTS: Results of the growth model indicated some limited cohort effects for chronologic age, years since injury, and age at injury onset at baseline. However, significant time effects were observed for each of the health indices, with hospitalizations and physician visits increasing and self-reported fitness decreasing. Significant cohort by time interactions were observed for both number of hospitalizations and days hospitalized with years post injury and chronologic age. CONCLUSION: The natural course of change in the health indices was in the direction of a greater need for treatment and reduced fitness over time. Aging effects, as defined by cohort by time interactions, indicated the greater need for hospitalization increased over time at a greater rate for those with more years post injury and of older ages.

Language: en