Kay Elizabeth, Deutsch Anne, Chen David, Semik Patrick, Rowles Diane
Center for Rehabilitation Outcomes Research, Rehabilitation Institute of Chicago, Chicago, Illinois 60611, USA.
J Spinal Cord Med. 2010;33(4):379-86. doi: 10.1080/10790268.2010.11689716.
To examine gender differences in rehabilitation outcomes for patients with nontraumatic spinal cord injury.
Secondary analysis was conducted on Medicare beneficiary data from 65 to 74 year olds with incomplete paraplegia discharged from inpatient rehabilitation facilities in 2002 through 2005.
Length of stay, Functional Independence Measure instrument motor item and subscale scores on discharge, and discharge destination.
Among patients with degenerative spinal disease, men had significantly longer rehabilitation stays than women (P < 0.001). Men with degenerative spinal disease had significantly lower discharge Functional Independence Measure scores than women, indicating more dependence in self-care (P < 0.001) and mobility (P < 0.001). Among patients with degenerative spinal disease, men were less likely to walk (odds ratio = 0.58; 95% CI = 0.38-0.87) and less likely to be independent with bladder management (odds ratio = 0.44; 95% CI = 0.31-0.62). Among patients with vascular ischemia, men were more independent (B = 2.59; 99% CI = 0.42-4.76) in mobility than women. There were no gender differences in the malignant spinal tumors group. There were no gender differences in being discharged to a community-based residence.
Gender distributions varied by etiology. Gender differences were found in demographics, length of stay, and functional outcomes but not discharge destination. Men were more dependent than women at discharge in the etiology group with the least overall disability (degenerative spinal disease) and more independent in mobility than women at discharge in the etiology group with the most overall disability (vascular ischemia).
研究非创伤性脊髓损伤患者康复结局的性别差异。
对2002年至2005年从住院康复机构出院的65至74岁不完全性截瘫的医疗保险受益人的数据进行二次分析。
住院时间、出院时功能独立性测量工具的运动项目及分量表得分，以及出院去向。
在患有退行性脊柱疾病的患者中，男性的康复住院时间显著长于女性（P < 0.001）。患有退行性脊柱疾病的男性出院时功能独立性测量得分显著低于女性，表明在自我护理（P < 0.001）和活动能力（P < 0.001）方面更依赖他人。在患有退行性脊柱疾病的患者中，男性行走的可能性较小（优势比 = 0.58；95%可信区间 = 0.38 - 0.87），膀胱管理独立的可能性较小（优势比 = 0.44；95%可信区间 = 0.31 - 0.62）。在患有血管性缺血的患者中，男性在活动能力方面比女性更独立（B = 2.59；99%可信区间 = 0.42 - 4.76）。在恶性脊柱肿瘤组中没有性别差异。在出院到社区住所方面没有性别差异。
性别分布因病因不同而有所差异。在人口统计学、住院时间和功能结局方面发现了性别差异，但在出院去向方面没有。在总体残疾程度最低的病因组（退行性脊柱疾病）中，男性出院时比女性更依赖他人；在总体残疾程度最高的病因组（血管性缺血）中，男性出院时在活动能力方面比女性更独立。
