Etiology and incidence of rehospitalization after traumatic spinal cord injury: A multicenter analysis

Diana D. Cardenas, Jeanne M. Hoffman, Steven Kirshblum, William McKinley

Research output: Contribution to journalArticle

280 Citations (Scopus)

Abstract

Cardenas DD, Hoffman JM, Kirshblum S, McKinley W. Etiology and incidence of rehospitalization after traumatic spinal cord injury: a multicenter analysis. Arch Phys Med Rehabil 2004;85:1757-63. Objectives To examine the frequency and reasons for rehospitalization in persons with acute traumatic spinal cord injury (SCI) during follow-up years and to examine the association between rehospitalization and demographics, neurologic category, payer sources, length of stay (LOS), discharge motor FIM instrument score, and discharge residence. Design Survey design with analysis of cross-sectional data. Setting Model Spinal Cord Injury Systems (MSCIS) centers. Participants Data for 8668 persons with SCI from 16 MSCIS centers entered in the National Spinal Cord Injury Statistical Center database between 1995 and 2002. Interventions Not applicable. Main outcome measures MSCIS Forms I and II were used to identify the annual incidence, medical complications, and etiologies of rehospitalizations reported at 1-, 5-, 10-, 15-, and 20-year follow-ups. Results The leading cause of rehospitalization was diseases of the genitourinary system, including urinary tract infections (UTIs). Diseases of the respiratory system tended to be more likely in patients with tetraplegia (C1-8 American Spinal Injury Association [ASIA] grades A, B, C); whereas patients with paraplegia (T1-S5 ASIA grades A, B, C) were more likely to be rehospitalized for pressure ulcers. The rate of rehospitalization was significantly higher at year 1, 5, and 20 for those who were discharged to a skilled nursing facility after acute rehabilitation. Lower motor score using the FIM was predictive of rehospitalization (P=.000). The average LOS per rehospitalization at the year-5 follow-up was approximately 12 days, which is lower than in past MSCIS reports. Conclusions Despite improvements in SCI medical management, rehospitalization rates remain high, with an increased incidence in conditions associated with the genitourinary system (including UTIs), respiratory complications (including pneumonia), and diseases of the skin (including pressure ulcers). Acutely injured patients need close follow-up to reduce morbidity and rehospitalizations.

Original languageEnglish
Pages (from-to)1757-1763
Number of pages7
JournalArchives of Physical Medicine and Rehabilitation
Volume85
Issue number11
DOIs
StatePublished - Nov 1 2004
Externally publishedYes

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Spinal Cord Injuries
Incidence
Urogenital System
Pressure Ulcer
Urinary Tract Infections
Length of Stay
Skilled Nursing Facilities
Spinal Injuries
Quadriplegia
Paraplegia
Skin Diseases
Respiratory System
Nervous System
Pneumonia
Rehabilitation
Cross-Sectional Studies
Demography
Outcome Assessment (Health Care)
Databases
Morbidity

Keywords

  • Hospitalization
  • Rehabilitation
  • Spinal cord injuries

ASJC Scopus subject areas

  • Rehabilitation

Cite this

Etiology and incidence of rehospitalization after traumatic spinal cord injury : A multicenter analysis. / Cardenas, Diana D.; Hoffman, Jeanne M.; Kirshblum, Steven; McKinley, William.

In: Archives of Physical Medicine and Rehabilitation, Vol. 85, No. 11, 01.11.2004, p. 1757-1763.

Research output: Contribution to journalArticle

Cardenas, Diana D. ; Hoffman, Jeanne M. ; Kirshblum, Steven ; McKinley, William. / Etiology and incidence of rehospitalization after traumatic spinal cord injury : A multicenter analysis. In: Archives of Physical Medicine and Rehabilitation. 2004 ; Vol. 85, No. 11. pp. 1757-1763.
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N2 - Cardenas DD, Hoffman JM, Kirshblum S, McKinley W. Etiology and incidence of rehospitalization after traumatic spinal cord injury: a multicenter analysis. Arch Phys Med Rehabil 2004;85:1757-63. Objectives To examine the frequency and reasons for rehospitalization in persons with acute traumatic spinal cord injury (SCI) during follow-up years and to examine the association between rehospitalization and demographics, neurologic category, payer sources, length of stay (LOS), discharge motor FIM instrument score, and discharge residence. Design Survey design with analysis of cross-sectional data. Setting Model Spinal Cord Injury Systems (MSCIS) centers. Participants Data for 8668 persons with SCI from 16 MSCIS centers entered in the National Spinal Cord Injury Statistical Center database between 1995 and 2002. Interventions Not applicable. Main outcome measures MSCIS Forms I and II were used to identify the annual incidence, medical complications, and etiologies of rehospitalizations reported at 1-, 5-, 10-, 15-, and 20-year follow-ups. Results The leading cause of rehospitalization was diseases of the genitourinary system, including urinary tract infections (UTIs). Diseases of the respiratory system tended to be more likely in patients with tetraplegia (C1-8 American Spinal Injury Association [ASIA] grades A, B, C); whereas patients with paraplegia (T1-S5 ASIA grades A, B, C) were more likely to be rehospitalized for pressure ulcers. The rate of rehospitalization was significantly higher at year 1, 5, and 20 for those who were discharged to a skilled nursing facility after acute rehabilitation. Lower motor score using the FIM was predictive of rehospitalization (P=.000). The average LOS per rehospitalization at the year-5 follow-up was approximately 12 days, which is lower than in past MSCIS reports. Conclusions Despite improvements in SCI medical management, rehospitalization rates remain high, with an increased incidence in conditions associated with the genitourinary system (including UTIs), respiratory complications (including pneumonia), and diseases of the skin (including pressure ulcers). Acutely injured patients need close follow-up to reduce morbidity and rehospitalizations.

AB - Cardenas DD, Hoffman JM, Kirshblum S, McKinley W. Etiology and incidence of rehospitalization after traumatic spinal cord injury: a multicenter analysis. Arch Phys Med Rehabil 2004;85:1757-63. Objectives To examine the frequency and reasons for rehospitalization in persons with acute traumatic spinal cord injury (SCI) during follow-up years and to examine the association between rehospitalization and demographics, neurologic category, payer sources, length of stay (LOS), discharge motor FIM instrument score, and discharge residence. Design Survey design with analysis of cross-sectional data. Setting Model Spinal Cord Injury Systems (MSCIS) centers. Participants Data for 8668 persons with SCI from 16 MSCIS centers entered in the National Spinal Cord Injury Statistical Center database between 1995 and 2002. Interventions Not applicable. Main outcome measures MSCIS Forms I and II were used to identify the annual incidence, medical complications, and etiologies of rehospitalizations reported at 1-, 5-, 10-, 15-, and 20-year follow-ups. Results The leading cause of rehospitalization was diseases of the genitourinary system, including urinary tract infections (UTIs). Diseases of the respiratory system tended to be more likely in patients with tetraplegia (C1-8 American Spinal Injury Association [ASIA] grades A, B, C); whereas patients with paraplegia (T1-S5 ASIA grades A, B, C) were more likely to be rehospitalized for pressure ulcers. The rate of rehospitalization was significantly higher at year 1, 5, and 20 for those who were discharged to a skilled nursing facility after acute rehabilitation. Lower motor score using the FIM was predictive of rehospitalization (P=.000). The average LOS per rehospitalization at the year-5 follow-up was approximately 12 days, which is lower than in past MSCIS reports. Conclusions Despite improvements in SCI medical management, rehospitalization rates remain high, with an increased incidence in conditions associated with the genitourinary system (including UTIs), respiratory complications (including pneumonia), and diseases of the skin (including pressure ulcers). Acutely injured patients need close follow-up to reduce morbidity and rehospitalizations.

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