PR_252: Inpatient Rehabilitation Outcomes for Myelopathy Patients Do Not Predict Satisfaction With Life

Abstract

Objective: To determine which inpatient rehabilitation outcome variables predict satisfaction with life after inpatient rehabilitation for myelopathy of traumatic or nontraumatic etiology. Design: Survey utilizing the Satisfaction With Life Scale (SWLS). Setting: Midwestern academic medical center. Participants: 759 people dismissed from inpatient rehabilitation for myelopathy between January 1, 1995, and December 31, 2003, were potential participants. Interventions: Not applicable. Main Outcome Measure: The SWLS. Results: 553 people were still alive to be surveyed. 348 people returned a completed SWLS, with a mean of 4.5±2.5 years after discharge from inpatient rehabilitation, yielding a final response rate of 63%. 60% of survey respondents were men. 57% of survey respondents had paraplegia and 91% had incomplete myelopathy. Mean age at admission was 56.9±18.2 years. Mean admission FIM score was 71.5±19.4 and mean discharge FIM score was 97.7±19.6. Median rehabilitation length of stay was 15 days (range, 1−141d). Mean SWLS was 19.1±7.6. The attempts to build a multivariate model resulted in a final model using age, dismissal FIM scores, FIM change, and diagnoses, but its predictive abilities were largely unsuccessful. Independent factors associated with decreased SWLS score: decreased age (P=.05), decreased discharge FIM scores (P<.001), and a nontraumatic cause for myelopathy (vascular, P=.006; spondylosis and stenosis, P=.001; cancer, P=.86; other nontraumatic spinal cord injury, P=.006) compared with trauma, after adjusting for change in FIM (P=.18). The predictive ability of the model was very poor, with a concordance of 3%. Conclusions: Demographic and rehabilitation measures such as age, FIM scores, and etiology are poor predictors of satisfaction with life after myelopathy rehabilitation.