Citation

Cheng CL, Plashkes T, Shen T, Fallah N, Humphreys S, O'Connell C, Linassi AG, Ho C, Short C, Ethans K, Charbonneau RME, Paquet J, Noonan VK. J. Neurotrauma 2017; 34(20): 2867-2876.

Affiliation

Rick Hansen Institute, Vancouver, British Columbia, Canada ; vnoonan@rickhanseninstitute.org.

Copyright

(Copyright © 2017, Mary Ann Liebert Publishers)

DOI

10.1089/neu.2016.4930

PMID

28447870

Abstract

Return to living at home is an important patient-reported outcome following traumatic spinal cord injury (tSCI). Specialized inpatient rehabilitation assists such patients in maximizing function and independence. Our project aim was to describe those patients receiving specialized rehabilitation after tSCI in Canada, and to determine if such rehabilitation improved the likelihood of returning home. This cohort study utilized data from RHSCIR to identify patients with tSCI discharged from 1 of 18 participating acute specialized spine facilities between 2011-2015 to either 1 of 13 participating specialized rehabilitation facilities, or another discharge destination. To determine if specialized rehabilitation affected likelihood of returning home, multiple logistic regressions and propensity score matchings were performed to account for age at injury, gender, neurological severity and level, acute length of stay, and region of residence. Chi-square test was used to compare rate of return home between matched groups. Of the 1599 patients included, 71% received specialized rehabilitation. Receiving specialized rehabilitation was a significant and strong predictor of return to home after controlling for covariates (adjusted odds ratio=3.1; 95% CI 1.6-5.9). The rate of return to home was significantly higher in the matched rehabilitation group than the no rehabilitation group (98% vs 87%, p=0.0004). For the matched patients, an extra 11 patients returned home for every 100 patients receiving specialized rehabilitation. However, effect of age on returning home requires further investigation. Improving access to specialized rehabilitation could potentially reduce discharges to nursing homes or other non-home destinations.

Language: en

Keywords

REHABILITATION; TRAUMATIC SPINAL CORD INJURY; spinal cord injury