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脊髓损伤患者多次住院再入院的相关因素。

Factors associated with multiple hospital readmissions for individuals with spinal cord injury.

作者信息

Canori Alexandra, Kumar Amit, Hiremath Shivayogi V

机构信息

Department of Health and Rehabilitation Sciences, College of Public Health, Temple University.

Center for Health Equity Research, Department of Physical Therapy and Athletic Training, Northern Arizona University.

出版信息

Commonhealth (Phila). 2020 Sep;1(2):57-61. doi: 10.15367/ch.v1i2.399. Epub 2020 Sep 28.

Abstract

OBJECTIVE

To identify patient-level and clinical factors associated with multiple hospital readmissions in individuals with spinal cord injury (SCI).

DESIGN

Retrospective cohort analysis of the publicly available dataset from the SCI Rehabilitation (SCIRehab) study.

SETTING

Six rehabilitation centers in the U.S. that participated in the SCIRehab study. Participants: Individuals with traumatic SCI (N=1371) who were consecutively enrolled in the SCIRehab study.

OUTCOME MEASURES

The primary outcome was all-cause hospital readmission within 1 year of discharge from a rehabilitation center. The patient-level and clinical factors include employment status, depression, caregiver support, state-funded insurance, functional status, and rehabilitation services.

RESULTS

Of the 1170 participants included in the study, 228 were readmitted once and 120 were readmitted multiple times. In our study, 34.2% and 10.8% were readmitted more than once due to genitourinary and respiratory conditions, respectively. Lower utilization of rehabilitation services, lower functional status, unemployment, and depression were associated with higher odds of being readmitted multiple times within one year of discharge from inpatient rehabilitation facility.

CONCLUSION

Psychosocial and clinical factors were associated with increased risk for multiple readmissions in individuals with SCI. In order to reduce recurrent readmissions in individuals with SCI, further research is necessary to maximize efficacy of risk factor modification and prevention strategies.

摘要

目的

确定脊髓损伤(SCI)患者多次住院再入院相关的患者层面因素和临床因素。

设计

对脊髓损伤康复(SCIRehab)研究的公开可用数据集进行回顾性队列分析。

地点

美国参与SCIRehab研究的六个康复中心。参与者:连续纳入SCIRehab研究的创伤性脊髓损伤患者(N = 1371)。

结局指标

主要结局是康复中心出院后1年内的全因住院再入院。患者层面因素和临床因素包括就业状况、抑郁、照料者支持、国家资助保险、功能状态和康复服务。

结果

研究纳入的1170名参与者中,228人再次入院一次,120人多次入院。在我们的研究中,分别有34.2%和10.8%的患者因泌尿生殖系统和呼吸系统疾病再次入院不止一次。康复服务利用率较低、功能状态较差、失业和抑郁与住院康复机构出院后一年内多次再入院的较高几率相关。

结论

心理社会因素和临床因素与脊髓损伤患者多次再入院风险增加相关。为了减少脊髓损伤患者的再次入院,有必要进一步研究以最大化危险因素修正和预防策略的效果。

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