Factors associated with post-acute functional status and discharge dispositions in individuals with spinal cord injury

The Journal of Spinal Cord Medicine, 2022 · DOI: 10.1080/10790268.2021.1888023 · Published: January 1, 2022

Spinal Cord Injury Trauma Rehabilitation

Simple Explanation

This study examines factors affecting functional outcomes and discharge destinations (home vs. institution) for individuals with spinal cord injury (SCI) using data from Pennsylvania. The research identifies that older age, longer hospital stays, and severity of injury are linked to lower functional scores and higher likelihood of discharge to institutions. Hispanic individuals, compared to White individuals, had lower odds of being discharged to an institution, highlighting potential disparities in post-acute care access.

Study Duration

2012 to 2017

Participants

2223 individuals with traumatic SCI

Evidence Level

Not specified

Key Findings

1
Older age, longer length of stay, lower Glasgow Coma Scale (GCS), higher Injury Severity Score (ISS), and tetraplegia were associated with lower motor functional scores at discharge.
2
Older age, public-sponsored insurance, longer length of stay, lower GCS, and higher ISS increased the odds of discharge to an institution.
3
Hispanic ethnicity was associated with lower odds of being discharged to an institution compared to White ethnicity.

Research Summary

This retrospective study analyzed data from 2223 individuals with traumatic SCI in Pennsylvania to identify factors associated with post-acute functional status and discharge disposition. The study found that demographic, clinical, and process of care factors significantly influenced both functional outcomes and discharge destinations, with older age and injury severity consistently predicting poorer outcomes. The models developed in this study were better at predicting discharge destination (home vs. institution) than predicting functional status at discharge from the acute hospital.

Practical Implications

Informing Trauma Care

The findings can inform trauma and acute care protocols post-SCI to improve functional outcomes and discharge planning.

Addressing Disparities

The results highlight the need to address potential disparities in post-acute care access for different ethnic groups.

Optimizing Rehabilitation

The identification of key predictors can aid in the early initiation of rehabilitation and discharge planning strategies.

Study Limitations

1
The study is a secondary data analysis of the PTOS database, limited to Pennsylvania.
2
Some findings are based on small sample sizes for certain demographic groups (e.g., Hispanic ethnicity).
3
Admission latency is based on reported injury time, which may be subject to error.

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