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Association Between Time to Rehabilitation and Outcomes After Traumatic Spinal Cord Injury

      Abstract

      Objective

      To examine the relations between time to rehabilitation after spinal cord injury (SCI) and rehabilitation outcomes at discharge and 1-year postinjury.

      Design

      Retrospective cohort study.

      Setting

      Facilities designated as Spinal Cord Injury Model Systems.

      Participants

      Patients (N=3937) experiencing traumatic SCI between 2000 and 2014, who were 18 years or older, and who were admitted to a model system within 24 hours of injury.

      Interventions

      Not applicable.

      Main Outcome Measures

      Rasch-transformed FIM motor score at discharge and 1-year postinjury, discharge to a private residence, and the Craig Handicap Assessment and Reporting Technique (CHART) Physical Independence and Mobility scores at 1-year postinjury.

      Results

      After accounting for health status, a 10% increase in time to rehabilitation was associated with a 1.50 lower FIM motor score at discharge (95% confidence interval [CI], −2.43 to −0.58; P=.001) and a 3.92 lower CHART Physical Independence score at 1-year postinjury (95% CI, −7.66 to −0.19; P=.04). Compared to the mean FIM motor score (37.5) and mean CHART Physical Independence score (74.7), the above-mentioned values represent relative declines of 4.0% and 5.3%, respectively. There was no association between time to rehabilitation and discharge to a private residence, 1-year FIM motor score, or the CHART mobility score.

      Conclusions

      Earlier rehabilitation after traumatic SCI may improve patients' functional status at discharge.

      Keywords

      List of abbreviations:

      AIS (ASIA Impairment Scale), CHART (Craig Handicap Assessment and Reporting Technique), CI (confidence interval), LOS (length of stay), OLS (ordinary least squares), SCI (spinal cord injury), SCIMS (Spinal Cord Injury Model Systems)
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