@article{ref1,
title="Association of ambulatory ability on complications and medical costs in patients with traumatic spinal cord injury: a decision-analytic model",
journal="Curēus",
year="2019",
author="Miller, Larry E. and Anderson, Louise H.",
volume="11",
number="8",
pages="e5337-e5337",
abstract="PURPOSE  The objective of this study was to determine the independent association of ambulatory ability with complications and medical costs in patients with spinal cord injury (SCI). <br><br>METHODS Patients with SCI between T1-T12 enrolled in the National Spinal Cord Injury Database (NSCID) provided a minimum one-year follow-up. Covariate-adjusted annual rates of important medical complications (pressure sore, urinary tract infection, hospitalization) and associated medical costs were determined over five years post-injury.  Results A total of 1,753 patients provided data at one-year follow-up and 1,340 patients provided five-year data. At one-year post-injury, 82% of patients were non-ambulatory and 18% were ambulatory. After adjusting for important covariates, ambulatory status was associated with a lower annual probability of urinary tract infection (43% vs. 68%), pressure sore (12% vs. 35%), and hospitalization (23% vs. 34%). Covariate-adjusted base-case medical costs due to urinary tract infection, pressure sore, and hospitalization were 34% lower in ambulatory vs. non-ambulatory patients ($31,358 vs. $47,266) over five years. Probabilistic sensitivity analyses confirmed the base-case results. <br><br>CONCLUSION In spinal cord-injured individuals, the ability to ambulate is independently associated with lower complication risks and associated medical costs over the five-year period following injury. Long-term clinical benefit and cost savings may be realized with assisted or unassisted ambulation in spinal cord-injured patients.<br><br>Copyright © 2019, Miller et al.<p /> <p>Language: en</p>",
language="en",
issn="2168-8184",
doi="10.7759/cureus.5337",
url="http://dx.doi.org/10.7759/cureus.5337"
}