Document Detail


Relationship of patient characteristics and rehabilitation services to outcomes following spinal cord injury: the SCIRehab project.
MedLine Citation:
PMID:  23318033     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND/OBJECTIVE: To examine associations of patient characteristics along with treatment quantity delivered by seven clinical disciplines during inpatient spinal cord injury (SCI) rehabilitation with outcomes at rehabilitation discharge and 1-year post-injury.
METHODS: Six inpatient SCI rehabilitation centers enrolled 1376 patients during the 5-year SCIRehab study. Clinicians delivering standard care documented details of treatment. Outcome data were derived from SCI Model Systems Form I and II and a project-specific interview conducted at approximately 1-year post-injury. Regression modeling was used to predict outcomes; models were cross-validated by examining relative shrinkage of the original model R(2) using 75% of the dataset to the R(2) for the same outcome using a validation subsample.
RESULTS: Patient characteristics are strong predictors of outcome; treatment duration adds slightly more predictive power. More time in physical therapy was associated positively with motor Functional Independence Measure at discharge and the 1-year anniversary, CHART Physical Independence, Social Integration, and Mobility dimensions, and smaller likelihood of rehospitalization after discharge and reporting of pressure ulcer at the interview. More time in therapeutic recreation also had multiple similar positive associations. Time spent in other disciplines had fewer and mixed relationships. Seven models validated well, two validated moderately well, and four validated poorly.
CONCLUSION: Patient characteristics explain a large proportion of variation in multiple outcomes after inpatient rehabilitation. The total amount of treatment received during rehabilitation from each of seven disciplines explains little additional variance. Reasons for this and the phenomenon that sometimes more hours of service predict poorer outcome, need additional study. Note: This is the first of nine articles in the SCIRehab series.
Authors:
Gale Whiteneck; Julie Gassaway; Marcel P Dijkers; Allen W Heinemann; Scott E D Kreider
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The journal of spinal cord medicine     Volume:  35     ISSN:  1079-0268     ISO Abbreviation:  J Spinal Cord Med     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2013-01-15     Completed Date:  2013-02-26     Revised Date:  2013-11-05    
Medline Journal Info:
Nlm Unique ID:  9504452     Medline TA:  J Spinal Cord Med     Country:  England    
Other Details:
Languages:  eng     Pagination:  484-502     Citation Subset:  IM    
Affiliation:
Department of Research, Craig Hospital, Englewood, CO, USA. gale@craig-hospital.org
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MeSH Terms
Descriptor/Qualifier:
Activities of Daily Living*
Adolescent
Adult
Evidence-Based Medicine
Female
Follow-Up Studies
Humans
Male
Middle Aged
Movement Disorders / etiology,  rehabilitation
Nervous System Diseases / etiology*,  rehabilitation
Regression Analysis
Rehabilitation Centers
Retrospective Studies
Severity of Illness Index
Social Behavior
Spinal Cord Injuries / complications,  psychology*,  rehabilitation*
Treatment Outcome
Young Adult
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