Factors associated with discharge destination following inpatient functional rehabilitation in patients with traumatic spinal cord injury.

STUDY

DESIGN

Retrospective review of data from a prospective database of a Level 1 trauma center.

OBJECTIVES

This project aims to identify factors collected during the acute and rehabilitative care following a traumatic spinal cord injury (TSCI) associated with success and failure to return home after inpatient intensive functional rehabilitation (IFR).

SETTING

Level 1 trauma center specialized in TSCI care in Montreal, Canada.

METHODS

All eligible patients from our prospective database were separated into two groups according to discharge destination following IFR. Clinical variables collected during the acute and rehabilitative care as well as demographic variables were compared between patients who managed to return home (Group 1) and those who were discharged elsewhere (Group 2). Multivariable regression analyses were conducted with variables that were significant at the univariate level.

RESULTS

Out of the 193 patients included, 22 (11%) failed to return home following IFR. Six variables were associated with failure to return home at the univariate level: longer acute length of stay (LOS), longer rehabilitation LOS, living alone, higher neurological level of injury, having comorbidities, and having a pressure injury (PI) during acute care. Three variables remained significant at the multivariate level: living alone, increasing acute LOS and presenting a high cervical (C1-C4) neurological level of injury.

CONCLUSIONS

It is important that acute care clinicians recognize the aforementioned factors early after TSCI in order to optimize patients for community reintegration.