Poster 191: Rehabilitation outcomes in spinal cord injury: persons in isolation versus nonisolation.

Abstract

Objective: To compare the rehabilitation outcomes of persons with spinal cord injury (SCI) on isolation precautions for antibiotic resistant organisms (for vancomycin-resistant Enterococcus faecium or methcillin-resistant Staphylococcus aureus) with patients who are not. Design: Retrospective chart review. Setting: Acute inpatient rehabilitation hospital. Participants: 58 consecutive admissions with SCI from January 1999 to December 1999, 11 in isolation (ISO) and 47 in nonisolation (non-ISO). Interventions: Not applicable. Main Outcome Measures: Length of stay (LOS), total charges, FIM™ instrument change, and FIM efficiency. Results: For the ISO and non-ISO groups, the mean of LOS ± SD was 73.73±47.92 days and 24.57±21.78 days, respectively; total charges were $111,804.91±$74,980.83 and $28,682.20±$26,448.38, respectively; FIM change was 11.91±12.02 and 19.55±15.90, respectively; and FIM efficiency score was .2867±.4265 and 1.4276±1.5205, respectively. ISO patients, compared with non-ISO, had a statistically significant increased LOS, increased charges, and lower FIM efficiency scores. No statistical significance was seen in FIM change between the 2 groups. Conclusions: We found that persons with SCI in isolation had a significantly longer LOS and increased medical charges resulting in lower FIM efficiency score. Ultimately, FIM changes did not differ significantly between groups. Thus, both groups eventually reached similar functional gains, but the nonisolation group reached them with a lower LOS, less cost, and greater efficiency.