Rehospitalization in the First Year of Traumatic Spinal Cord Injury After Discharge From Medical Rehabilitation

DeJong, Gerben; Tian, Weijun; Hsieh, Ching Hui; Junn, Cherry; Karam, Christopher; Ballard, Pamela; Smout, Randall J.; Horn, Susan D.; Zanca, Jeanne M.; Heinemann, Allen W.; Hammond, Flora M.; Backus, Deborah

doi:10.1016/j.apmr.2012.10.037

Cited by 169 publications

(138 citation statements)

References 36 publications

(44 reference statements)

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“…In the US, examination of health-care utilization has primarily focused on re-hospitalization, with the rate in the first year after traumatic SCI among non-veterans administration (VA) cohorts reported as 27.2-33%. [8][9][10] The rate of re-hospitalization in a 5-year VA-based cohort was as high as 90%. 7 DeJong et al 9 prospectively examined the reasons for re-hospitalization in 951 patients with acute traumatic SCI and found that genitourinary, respiratory, and diseases of the skin and soft tissue were the most common admission diagnoses, which were similar to an earlier study.…”

Section: Discussionmentioning

confidence: 99%

Examining health-care utilization in the first year following spinal cord injury

Skelton

Hoffman

Reyes

et al. 2014

The Journal of Spinal Cord Medicine

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Objective: To identify factors associated with health-care utilization during the first year after inpatient rehabilitation (IR) in individuals with traumatic spinal cord injury (SCI). Design: Prospective cohort. Methods: One hundred and sixty-eight patients were prospectively enrolled and followed over 1 year after discharge from an SCI Model System IR program. Telephone follow-up occurred at 3, 6, 9, and 12 months. Participants were grouped into four impairment levels (C1-4 American Spinal Injury Association (ASIA) Impairment Scale (AIS) A-C, C5-C8 AIS A-C, paraplegia AIS A-C, and all AIS D). Three domains of healthcare utilization were examined: hospital care, outpatient provider visits, and home services. Results: Health-care utilization in the first year following IR was high with 45% of subjects reporting rehospitalization. Twenty percent of patients were initially discharged to a skilled nursing facility (SNF), and an additional 10% required SNF care during this first year. Overall, those with C1-4 AIS A-C used the most services. Participants discharged home used less health care compared to those discharged elsewhere. SCI due to falls (vs. vehicular crashes) was associated with fewer in-home service visits. Age, sex, race, and education were unrelated to higher use. Conclusion: Those with greater neurological impairment or not discharged home after IR had higher health-care utilization, while age was not associated with utilization. Targeted efforts to reduce genitourinary and respiratory complications may reduce the need for hospital care in the first year after IR.

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Section: Discussionmentioning

confidence: 99%

Examining health-care utilization in the first year following spinal cord injury

Skelton

Hoffman

Reyes

et al. 2014

The Journal of Spinal Cord Medicine

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“…[6][7][8][9] The most frequent reasons for hospitalizations are UTIs, 2,9 respiratory problems 1,3,9 and pressure ulcers, 1,9 with pressure ulcers requiring longer hospitalizations. 1, 3,4 Greater risk of hospitalization is associated with low FIM scores, 2 delayed rehabilitation, 3 neurological impairment, 5 duration of injury, 2 reduced community integration 2 and type of health coverage. 1,5 Data are somewhat inconclusive on whether ethnic minorities are at greater 5 or reduced 1 risk of hospitalization.…”

Section: Introductionmentioning

confidence: 99%

“…For instance, individuals with SCI are 2.4 times more likely to be hospitalized than the general population, 1,2 and the length of hospitalization ranges from 4 to 17 days. 1, [3][4][5] In addition to direct costs, hospitalization creates both personal and familial strain, leads to reduced work or school days, and hinders independence and community integration. 1, 3 Yet, many hospital readmissions are avoidable with prevention or proper management of secondary health conditions.…”

Section: Introductionmentioning

confidence: 99%

“…1, [3][4][5] In addition to direct costs, hospitalization creates both personal and familial strain, leads to reduced work or school days, and hinders independence and community integration. 1, 3 Yet, many hospital readmissions are avoidable with prevention or proper management of secondary health conditions. 3,6 There are a number of reasons that people with SCI are at greater risk of hospitalization, including multiple medical complications associated with SCI such as urinary tract infections (UTIs), pressure ulcers, pain, respiratory infection, cardiovascular disease, osteoporosis and depression.…”

Section: Introductionmentioning

confidence: 99%

“…1, 3 Yet, many hospital readmissions are avoidable with prevention or proper management of secondary health conditions. 3,6 There are a number of reasons that people with SCI are at greater risk of hospitalization, including multiple medical complications associated with SCI such as urinary tract infections (UTIs), pressure ulcers, pain, respiratory infection, cardiovascular disease, osteoporosis and depression. [6][7][8][9] The most frequent reasons for hospitalizations are UTIs, 2,9 respiratory problems 1,3,9 and pressure ulcers, 1,9 with pressure ulcers requiring longer hospitalizations.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Predictive factors of hospitalization in adults with pediatric-onset SCI: a longitudinal analysis

et al. 2015

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Study design: Longitudinal survey. Objectives: To investigate the prevalence and rate of hospitalization among adults with pediatric-onset spinal cord injury (SCI) and explore medical and behavioral factors associated with hospitalization. Methods: This study included 368 adults who sustained a SCI prior to age 19 and were enrolled in an ongoing longitudinal study investigating the outcomes of pediatric-onset SCI. Participants were interviewed on an approximately annual basis using a studyspecific questionnaire and standardized outcome measures: Satisfaction with Life Scale; Short-Form 12 Health Survey; Alcohol Use Disorders Identification Test; Patient Health Questionnaire-9 Depression Scale; and Craig Handicap Assessment and Recording Technique. Results: Overall, 61% of participants self-reported at least one hospitalization across all time points; average length of hospitalization was 14.8 days (±23.3). Individuals who were ethnic minorities as well as those with high cervical-level SCI were more likely to be hospitalized. Those who were unemployed and those with health-care coverage were more likely to be hospitalized and have longer hospitalization stays. The risk of hospitalization was higher with occurrence of pressure ulcers, urinary tract infections, pneumonia, pain and a chronic medical condition. Smoking cigarettes increased the risk of hospitalization, whereas those who engaged in exercise and were active in the community had lower odds of hospitalization. Conclusion: Both medical and lifestyle factors have an important role in predicting hospitalization. An increased understanding of the risk and protective factors associated with hospitalization should assist clinicians in developing strategies and prevention efforts to minimize secondary health complications and foster healthy lifestyle behaviors.

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Prediction of bladder outcomes after ischemic spinal cord injury: A longitudinal cohort study from the European multicenter study about spinal cord injury

Scivoletto

Pavese

Bachmann

et al. 2018

Neurourology and Urodynamics

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Rehospitalization in the First Year of Traumatic Spinal Cord Injury After Discharge From Medical Rehabilitation

Cited by 169 publications

References 36 publications

Examining health-care utilization in the first year following spinal cord injury

Examining health-care utilization in the first year following spinal cord injury

Predictive factors of hospitalization in adults with pediatric-onset SCI: a longitudinal analysis

Prediction of bladder outcomes after ischemic spinal cord injury: A longitudinal cohort study from the European multicenter study about spinal cord injury

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