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脊髓损伤匹配样本在急性康复住院时间、费用及功能结局方面的性别差异:一项多中心调查

Gender-related differences in acute rehabilitation lengths of stay, charges, and functional outcomes for a matched sample with spinal cord injury: a multicenter investigation.

作者信息

Greenwald B D, Seel R T, Cifu D X, Shah A N

机构信息

Department of Physical Medicine and Rehabilitation, University of Medicine and Dentistry-New Jersey Medical School, Newark, NJ 07103, USA.

出版信息

Arch Phys Med Rehabil. 2001 Sep;82(9):1181-7. doi: 10.1053/apmr.2001.24891.

Abstract

OBJECTIVE

To examine the effects of gender on length of stay (LOS), treatment costs, and outcomes by using a matched sample of patients with spinal cord injury (SCI).

DESIGN

A 2 x (15 x 3) mixed, block design was used retrospectively to analyze the impact of gender on subjects matched for age, American Spinal Injury Association (ASIA) motor impairment classification, and level of neurologic injury.

SETTING

Twenty medical centers in the federally sponsored Spinal Cord Injury Model Systems project.

PARTICIPANTS

One thousand seventy-four adult patients with SCI admitted between 1988 and 1998 were assessed at acute-care admission, inpatient rehabilitation admission, and inpatient rehabilitation discharge.

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURES

ASIA motor index and FIM instrument admission, discharge, and efficiency scores; rehabilitation LOS and medical care charges; and discharge disposition.

RESULTS

Analysis revealed no gender-related differences in FIM motor scores on admission and discharge. No differences in FIM motor efficiencies or daily change were observed. No significant differences were found for ASIA motor scores on acute-care admission and rehabilitation discharge. No differences in acute rehabilitation LOS and charges were observed. No gender-related differences were seen in the likelihood of discharge to an institutional setting.

CONCLUSION

Gender was not a significant factor in functional outcome of SCI patients after acute rehabilitation.

摘要

目的

通过对脊髓损伤(SCI)患者的匹配样本进行研究,探讨性别对住院时间(LOS)、治疗费用及治疗结果的影响。

设计

采用2×(15×3)混合区组设计,对年龄、美国脊髓损伤协会(ASIA)运动功能障碍分级及神经损伤水平相匹配的受试者进行回顾性分析,以研究性别对其的影响。

地点

联邦政府资助的脊髓损伤模型系统项目中的20个医疗中心。

参与者

对1988年至1998年间收治的1074例成年SCI患者在急性护理入院、住院康复入院及住院康复出院时进行评估。

干预措施

不适用。

主要观察指标

ASIA运动指数以及FIM工具的入院、出院及效率评分;康复住院时间及医疗费用;出院去向。

结果

分析显示,入院及出院时FIM运动评分无性别差异。FIM运动效率及每日变化也无差异。急性护理入院及康复出院时ASIA运动评分无显著差异。急性康复住院时间及费用无差异。出院至机构环境的可能性无性别差异。

结论

急性康复后,性别并非SCI患者功能结局的显著影响因素。

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