Predictors of readmission to acute care during inpatient rehabilitation for non-traumatic spinal cord injury |
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Authors: | David M. Robinson Moussa S. Bazzi Scott R. Millis Ali A. Bitar |
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Affiliation: | 1. School of Medicine, Wayne State University, Detroit, Michigan, USA;2. Department of Physical Medicine and Rehabilitation, Rehabilitation Institute of Michigan, Detroit, Michigan, USA |
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Abstract: | Objectives: To investigate the frequency of and reasons for readmissions to acute care (RTAC) during inpatient rehabilitation (IPR) after non-traumatic spinal cord injury (NT-SCI). To develop a predictive model for RTAC using identified risk factors.Design: Retrospective case-control.Setting: Academic IPR hospital.Participants: Individuals with NT-SCI admitted to an academic SCI rehabilitation unit from January 2014-December 2015.Interventions: Not applicable.Main Outcome Measures: Readmissions to acute care services from IPR.Results: Thirty-seven participants (20%) experienced a RTAC for a total of 39 episodes. Thirty-five experienced 1 RTAC, while two had 2. The most common medical reasons for RTAC were infection (27%), neurological (27%), and noninfectious respiratory (16%). Multivariable logistic regression was used to develop a model to predict RTAC. Paraplegia was associated with 3.2 times increase in the odds of RTAC (P?=?0.03). For every unit increase in FIM-Motor, there was a 5% reduction in the odds of RTAC (P?=?0.03) Body mass index less than 30 decreased odds of RTAC by 61% (P?=?0.004).Conclusion: RTACs were associated with body mass index greater than 30, decreased FIM-Motor subscore on admission, and paraplegia. Physiatrists caring for the non-traumatic SCI patient need be more circumspect of individuals with these parameters to potentially prevent the problems necessitating acute care transfer. |
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Keywords: | Spinal cord injuries Quality measures Outcome assessment Rehabilitation Patient readmission |
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