Meade MA, Cifu DX, Seel RT, McKinley WO, Kreutzer JS. Medical procedures, complications, and outcomes for patients with spinal cord injury: a multicenter investigation comparing African Americans and whites. Arch Phys Med Rehabil 2004;85:368–75.
To examine the role of race on rehabilitation outcomes for a matched sample of patients with spinal cord injury (SCI).
African Americans and whites with SCI were matched based on age group, level and completeness of injury, and sponsor of care to retrospectively analyze the impact of race.
Eighteen medical centers in the federally sponsored Model Spinal Cord Injury Systems project.
A total of 628 adults with SCI.
Main outcome measures
Medical procedures and complications; American Spinal Injury Association motor index, and FIMT instrument scores at admission and discharge; and discharge dispositions.
Analysis revealed race-related differences in spinal surgeries, laparotomies, traction during acute care, and method of bladder management at discharge. In most cases, these were explained by cause of injury rather than direct affects of race. No differences were found with regard to medical complications functional outcomes, or discharge disposition.
Although differences exist in the medical procedures given to African Americans and whites with SCI, they are generally accounted for by cause of injury rather than the direct affects of race.
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- In the nation’s interest: equity in access of health care: project on health care needs for Hispanics and African Americans.Summary report from the Joint Center for Politics and Economic Studies. Joint Center for Political and Economic Studies, Washington (DC)1995
- Spinal cord injury.J Spinal Cord Med. 2001; 24: 212-213
- Smedley B.D. Stith A.Y. Nelson A.R. Committee on Understanding and Eliminating Racial and Ethnic Disparities in Health Care, Institute of Medicine. Unequal treatment: confronting racial and ethnic disparities in health care. Natl Acad Pr, Washington (DC)2002
- Health care for black and poor hospitalized Medicare patients.JAMA. 1994; 271: 1169-1174
- Continuing differences in the rates of percutaneous transluminal coronary angioplasty and coronary artery graft surgery rates between elderly black and white Medicare beneficiaries.Am Heart J. 1994; 271: 287-295
- Factors predictive of stroke outcome in a rehabilitative setting.Neurology. 1996; 47: 388-392
- African-American and white patients admitted to the intensive care unit.Crit Care Med. 1995; 23: 626-636
- Rehabilitation after hip fracture—equal opportunity for all?.Arch Phys Med Rehabil. 1996; 77: 58-63
- Racial differences in the use of total knee arthroplasty for osteoarthritis among older Americans.Ethn Dis. 1994; 4: 57-67
- Firearm versus motor vehicle related spinal cord injury.Arch Phys Med Rehabil. 1997; 78: 150-155
- A comparative study of outcome and expenses following tetraplegia and paraplegia.J Spinal Cord Med. 2000; 23: 228-233
- Depression after spinal cord injury.Arch Phys Med Rehabil. 2000; 81: 1099-1109
- Subjective well-being after spinal cord injury.Rehabil Psychol. 1998; 43: 282-296
- Epidemiology and risk factors for urinary tract infection following spinal cord injury.Arch Phys Med Rehabil. 1993; 74: 691-695
- Dietary and serum lipids in individuals with spinal cord injury living in the community.J Rehabil Res Dev. 2001; 38: 225-233
- Ethnicity effect on the serum lipid profile in persons with spinal cord injury.Arch Phys Med Rehabil. 1998; 79: 176-180
- Age, outcome, and rehabilitation costs after tetraplegia spinal cord injury.Neurorehabilitation. 1999; 12: 177-185
- A multicenter investigation of age-related differences in lengths of stay, hospitalization charges, and outcomes for a matched tetraplegia sample.Arch Phys Med Rehabil. 1999; 80: 733-740
- The National Spinal Cord Injury Collaborative Database.in: Stover S.L. DeLisa J.A. Whiteneck G.G. Spinal cord injury clinical outcomes from the model systems. Aspen, Gaithersburg1995: 10-20
- Standards manual and interpretive guidelines for medical rehabilitation. CARF, Tucson1997
- International standards for neurological and functional classification of spinal cord injury—revised. ASIA, Chicago1996
- Guide for the Uniform Data System for Medical Rehabilitation (adult FIM). State Univ New York, Buffalo1996
- The functional independence measure.Arch Phys Med Rehabil. 1996; 77: 1101-1108
- Using multivariate statistics. 2nd ed. Harper Collins, New York1989
- Design and analysis. Prentice Hall, Englewood Cliffs1991
- Statistics. 5th ed. Harcourt Brace, New York1994
- Computational handbook of statistics. Addison Wesley Longman, Reading (MA)1997
- Relationship between type of health insurance and time to inpatient rehabilitation placement for surgical subspecialty patients.Am J Med Qual. 2001; 16: 212-215
- The racial/ethnic demography of disability.J Rehabil. 1997; 64: 9-16
- Management of gastrointestinal, genitourinary, and sexual function.in: Stover S.L. DeLisa J.A. Whiteneck G.G. Spinal cord injury clinical outcomes from the model systems. Aspen, Gaithersburg1995: 128-132
- Long-term medical complications after traumatic spial cord injury.Arch Phys Med Rehabil. 1999; 80: 1402-1410
- Culture and disability and the rehabilitation experience.in: Frank R.G. Elliott T.R. Handbook of rehabilitation psychology. American Psychological Association, Washington (DC)2000: 585-600
☆Supported in part by the National Institute on Disability and Rehabilitation Research, US Department of Education (grant no. H113N000015).
© 2004 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.