Acute rehospitalizations during inpatient rehabilitation for spinal cord injury

Flora M. Hammond, Susan D. Horn, Randall J. Smout, David Chen, Gerben Dejong, William Scelza, Amitabh Jha, Pamela H. Ballard, Jessica Bloomgarden

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

Objectives: To investigate frequency of and reasons for readmission to acute care (RTAC) during inpatient rehabilitation after traumatic spinal cord injury (SCI), and to identify factors associated with RTAC. Design: Prospective observational cohort. Setting: Inpatient rehabilitation. Participants: Individuals with SCI (N=1376) consecutively admitted for inpatient rehabilitation; 1032 randomly selected for model development; 344 selected for model cross-validation. Interventions: Not applicable. Main Outcome Measures: RTAC, RTAC reasons, rehabilitation length of stay (LOS), discharge location and FIM, rehospitalization between discharge and year 1, and 1-year outcomes: FIM, Craig Handicap Assessment and Reporting Technique, and Patient Health Questionnaire-9. Results: Participants (n=116; 11%) experienced RTAC with a total 143 episodes - 96 patients experienced only 1 RTAC, while 14 had 2 RTACs, 5 had 3 RTACs, and 1 had 4 RTACs. The most common RTAC reasons were surgery (36%), infection (22%), noninfectious respiratory (14%), and gastrointestinal (8%). Mean days ± SD from rehabilitation admission to first RTAC was 27±30 days. Seventy-four (7%) patients had at least 1 RTAC for medical reasons and 46 (4%) for surgical reasons. Regression analyses indicated several variables were associated with RTACs: greater admission medical severity, lower admission cognitive FIM, pressure ulcer acquired in acute care, and study site. Medical RTACs were associated with higher body mass index, lower admission cognitive and motor FIM, payer, and study site. Predictors of surgical RTAC were longer time from injury to rehabilitation admission and study site. After controlling for the other variables, the only outcome RTAC influenced was longer rehabilitation LOS. Conclusions: Approximately 11% of SCI patients experience RTAC during the course of rehabilitation for a variety of medical and surgical reasons. RTACs are associated with longer rehabilitation LOS.

Original languageEnglish (US)
Pages (from-to)S98-S105
JournalArchives of physical medicine and rehabilitation
Volume94
Issue number4 SUPPL.
DOIs
StatePublished - Apr 1 2013

Fingerprint

Spinal Cord Injuries
Inpatients
Rehabilitation
Length of Stay
Patient Readmission
Pressure Ulcer
Body Mass Index
Regression Analysis
Outcome Assessment (Health Care)
Health
Wounds and Injuries
Infection

Keywords

  • Comorbidity
  • Patient readmission
  • Rehabilitation
  • Spinal cord injuries

ASJC Scopus subject areas

  • Rehabilitation
  • Physical Therapy, Sports Therapy and Rehabilitation

Cite this

Acute rehospitalizations during inpatient rehabilitation for spinal cord injury. / Hammond, Flora M.; Horn, Susan D.; Smout, Randall J.; Chen, David; Dejong, Gerben; Scelza, William; Jha, Amitabh; Ballard, Pamela H.; Bloomgarden, Jessica.

In: Archives of physical medicine and rehabilitation, Vol. 94, No. 4 SUPPL., 01.04.2013, p. S98-S105.

Research output: Contribution to journalArticle

Hammond, FM, Horn, SD, Smout, RJ, Chen, D, Dejong, G, Scelza, W, Jha, A, Ballard, PH & Bloomgarden, J 2013, 'Acute rehospitalizations during inpatient rehabilitation for spinal cord injury', Archives of physical medicine and rehabilitation, vol. 94, no. 4 SUPPL., pp. S98-S105. https://doi.org/10.1016/j.apmr.2012.11.051
Hammond, Flora M. ; Horn, Susan D. ; Smout, Randall J. ; Chen, David ; Dejong, Gerben ; Scelza, William ; Jha, Amitabh ; Ballard, Pamela H. ; Bloomgarden, Jessica. / Acute rehospitalizations during inpatient rehabilitation for spinal cord injury. In: Archives of physical medicine and rehabilitation. 2013 ; Vol. 94, No. 4 SUPPL. pp. S98-S105.
@article{3713273f35b446089033c27eff1aed58,
title = "Acute rehospitalizations during inpatient rehabilitation for spinal cord injury",
abstract = "Objectives: To investigate frequency of and reasons for readmission to acute care (RTAC) during inpatient rehabilitation after traumatic spinal cord injury (SCI), and to identify factors associated with RTAC. Design: Prospective observational cohort. Setting: Inpatient rehabilitation. Participants: Individuals with SCI (N=1376) consecutively admitted for inpatient rehabilitation; 1032 randomly selected for model development; 344 selected for model cross-validation. Interventions: Not applicable. Main Outcome Measures: RTAC, RTAC reasons, rehabilitation length of stay (LOS), discharge location and FIM, rehospitalization between discharge and year 1, and 1-year outcomes: FIM, Craig Handicap Assessment and Reporting Technique, and Patient Health Questionnaire-9. Results: Participants (n=116; 11{\%}) experienced RTAC with a total 143 episodes - 96 patients experienced only 1 RTAC, while 14 had 2 RTACs, 5 had 3 RTACs, and 1 had 4 RTACs. The most common RTAC reasons were surgery (36{\%}), infection (22{\%}), noninfectious respiratory (14{\%}), and gastrointestinal (8{\%}). Mean days ± SD from rehabilitation admission to first RTAC was 27±30 days. Seventy-four (7{\%}) patients had at least 1 RTAC for medical reasons and 46 (4{\%}) for surgical reasons. Regression analyses indicated several variables were associated with RTACs: greater admission medical severity, lower admission cognitive FIM, pressure ulcer acquired in acute care, and study site. Medical RTACs were associated with higher body mass index, lower admission cognitive and motor FIM, payer, and study site. Predictors of surgical RTAC were longer time from injury to rehabilitation admission and study site. After controlling for the other variables, the only outcome RTAC influenced was longer rehabilitation LOS. Conclusions: Approximately 11{\%} of SCI patients experience RTAC during the course of rehabilitation for a variety of medical and surgical reasons. RTACs are associated with longer rehabilitation LOS.",
keywords = "Comorbidity, Patient readmission, Rehabilitation, Spinal cord injuries",
author = "Hammond, {Flora M.} and Horn, {Susan D.} and Smout, {Randall J.} and David Chen and Gerben Dejong and William Scelza and Amitabh Jha and Ballard, {Pamela H.} and Jessica Bloomgarden",
year = "2013",
month = "4",
day = "1",
doi = "10.1016/j.apmr.2012.11.051",
language = "English (US)",
volume = "94",
pages = "S98--S105",
journal = "Archives of Physical Medicine and Rehabilitation",
issn = "0003-9993",
publisher = "W.B. Saunders Ltd",
number = "4 SUPPL.",

}

TY - JOUR

T1 - Acute rehospitalizations during inpatient rehabilitation for spinal cord injury

AU - Hammond, Flora M.

AU - Horn, Susan D.

AU - Smout, Randall J.

AU - Chen, David

AU - Dejong, Gerben

AU - Scelza, William

AU - Jha, Amitabh

AU - Ballard, Pamela H.

AU - Bloomgarden, Jessica

PY - 2013/4/1

Y1 - 2013/4/1

N2 - Objectives: To investigate frequency of and reasons for readmission to acute care (RTAC) during inpatient rehabilitation after traumatic spinal cord injury (SCI), and to identify factors associated with RTAC. Design: Prospective observational cohort. Setting: Inpatient rehabilitation. Participants: Individuals with SCI (N=1376) consecutively admitted for inpatient rehabilitation; 1032 randomly selected for model development; 344 selected for model cross-validation. Interventions: Not applicable. Main Outcome Measures: RTAC, RTAC reasons, rehabilitation length of stay (LOS), discharge location and FIM, rehospitalization between discharge and year 1, and 1-year outcomes: FIM, Craig Handicap Assessment and Reporting Technique, and Patient Health Questionnaire-9. Results: Participants (n=116; 11%) experienced RTAC with a total 143 episodes - 96 patients experienced only 1 RTAC, while 14 had 2 RTACs, 5 had 3 RTACs, and 1 had 4 RTACs. The most common RTAC reasons were surgery (36%), infection (22%), noninfectious respiratory (14%), and gastrointestinal (8%). Mean days ± SD from rehabilitation admission to first RTAC was 27±30 days. Seventy-four (7%) patients had at least 1 RTAC for medical reasons and 46 (4%) for surgical reasons. Regression analyses indicated several variables were associated with RTACs: greater admission medical severity, lower admission cognitive FIM, pressure ulcer acquired in acute care, and study site. Medical RTACs were associated with higher body mass index, lower admission cognitive and motor FIM, payer, and study site. Predictors of surgical RTAC were longer time from injury to rehabilitation admission and study site. After controlling for the other variables, the only outcome RTAC influenced was longer rehabilitation LOS. Conclusions: Approximately 11% of SCI patients experience RTAC during the course of rehabilitation for a variety of medical and surgical reasons. RTACs are associated with longer rehabilitation LOS.

AB - Objectives: To investigate frequency of and reasons for readmission to acute care (RTAC) during inpatient rehabilitation after traumatic spinal cord injury (SCI), and to identify factors associated with RTAC. Design: Prospective observational cohort. Setting: Inpatient rehabilitation. Participants: Individuals with SCI (N=1376) consecutively admitted for inpatient rehabilitation; 1032 randomly selected for model development; 344 selected for model cross-validation. Interventions: Not applicable. Main Outcome Measures: RTAC, RTAC reasons, rehabilitation length of stay (LOS), discharge location and FIM, rehospitalization between discharge and year 1, and 1-year outcomes: FIM, Craig Handicap Assessment and Reporting Technique, and Patient Health Questionnaire-9. Results: Participants (n=116; 11%) experienced RTAC with a total 143 episodes - 96 patients experienced only 1 RTAC, while 14 had 2 RTACs, 5 had 3 RTACs, and 1 had 4 RTACs. The most common RTAC reasons were surgery (36%), infection (22%), noninfectious respiratory (14%), and gastrointestinal (8%). Mean days ± SD from rehabilitation admission to first RTAC was 27±30 days. Seventy-four (7%) patients had at least 1 RTAC for medical reasons and 46 (4%) for surgical reasons. Regression analyses indicated several variables were associated with RTACs: greater admission medical severity, lower admission cognitive FIM, pressure ulcer acquired in acute care, and study site. Medical RTACs were associated with higher body mass index, lower admission cognitive and motor FIM, payer, and study site. Predictors of surgical RTAC were longer time from injury to rehabilitation admission and study site. After controlling for the other variables, the only outcome RTAC influenced was longer rehabilitation LOS. Conclusions: Approximately 11% of SCI patients experience RTAC during the course of rehabilitation for a variety of medical and surgical reasons. RTACs are associated with longer rehabilitation LOS.

KW - Comorbidity

KW - Patient readmission

KW - Rehabilitation

KW - Spinal cord injuries

UR - http://www.scopus.com/inward/record.url?scp=84875421820&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84875421820&partnerID=8YFLogxK

U2 - 10.1016/j.apmr.2012.11.051

DO - 10.1016/j.apmr.2012.11.051

M3 - Article

C2 - 23527777

AN - SCOPUS:84875421820

VL - 94

SP - S98-S105

JO - Archives of Physical Medicine and Rehabilitation

JF - Archives of Physical Medicine and Rehabilitation

SN - 0003-9993

IS - 4 SUPPL.

ER -