Comparison of patients managed in specialised spinal rehabilitation units with those managed in non-specialised rehabilitation units

Abstract

Prospective open cohort study. Compare the demographic characteristics and rehabilitation outcomes for both non-traumatic SCI (NT-SCI) and traumatic SCI (T-SCI) patients admitted into either specialist spinal cord injury rehabilitation units (SCIRUs) or non-specialist rehabilitation units (NSRUs). Rehabilitation units in Australia. The Australasian Rehabilitation Outcomes Centre maintains a national database on inpatients admitted to most (130/145) public and private rehabilitation units in Australia. Patients were included if they had a diagnosis of spinal cord injury (SCI) and were discharged between 1 January 2006 and 31 December 2006. Patients were excluded if admitted for <7 days, only for assessment, or were a readmission following a previous SCI. There were 668 patients with confirmed SCI admitted (NT-SCI n=361, 54.0%; T-SCI n=307, 46.0%). NT-SCI patients were much less likely to be admitted into a specialist SCIRU (30.5%) compared with T-SCI patients (70.4%). For both NT-SCI and T-SCI patients, those admitted to a specialist SCIRU tended to be younger (P=0.000), have a longer length of stay in rehabilitation (P=0.000), and lower Functional Independence Measure (FIM) motor subscale score on admission (P=0.000) than those admitted to a NSRU. For NT-SCI patients, after adjusting for covariates, those admitted into specialist SCIRU had greater improvement in their FIM motor score during rehabilitation. This finding was not demonstrated in T-SCI patients. There are differences in the characteristics of SCI patients admitted to SCIRU compared with NSRU. NT-SCI patients admitted to SCIRU have greater functional gain.