Craig Hospital, Englewood, Colorado, USA.
Department of Rehabilitation Medicine, University of Minnesota Medical School, Minneapolis, Minnesota, USA.
J Spinal Cord Med. 2021 Nov;44(6):870-885. doi: 10.1080/10790268.2021.1881875. Epub 2021 Mar 11.
To examine associations of patient characteristics and treatment quantity delivered during inpatient spinal cord injury (SCI) rehabilitation with outcomes at 5 years post-injury and compare them to the associations found at 1 year post-injury.
Observational study using Practice-Based Evidence research methodology in which clinicians documented treatment details. Regression modeling was used to predict outcomes.
Five inpatient SCI rehabilitation centers in the US.
Participants were 792 SCIRehab participants who were 12 years of age, gave informed consent, and completed both a 1-year and 5-year post-injury interview.
Outcome data were derived from Spinal Cord Injury Model Systems (SCIMS) follow-up interviews at 5 years post-injury and, similar to the 1-year SCIMS outcomes, included measures of physical independence, societal participation, life satisfaction, and depressive symptoms, as well as place of residence, school/work attendance, rehospitalization, and presence of pressure ulcers.
Consistent with 1-year findings, patient characteristics continue to be strong predictors of outcomes 5-years post-injury, although several variables add to the prediction of some of the outcomes. More time in physical therapy and therapeutic recreation were positive predictors of 1-year outcomes, which held less true at 5 years. Greater time spent with psychology and social work/case management predicted greater depressive symptomatology 5-years post-injury. Greater clinician experience was a predictor at both 1- and 5 -years, although the related positive outcomes varied across years.
Various outcomes 5-years post-injury were primarily explained by pre-and post-injury characteristics, with little additional variance offered by the quantity of treatment received during inpatient rehabilitation.
研究住院脊髓损伤（SCI）康复期间患者特征和治疗量与损伤后 5 年结局的关系，并将其与损伤后 1 年的关系进行比较。
采用基于实践的证据研究方法进行观察性研究，临床医生记录治疗细节。回归模型用于预测结果。
美国 5 家住院 SCI 康复中心。
792 名 SCIRehab 参与者符合 12 岁，同意参加，并完成了 1 年和 5 年的损伤后访谈。
结果数据来自脊髓损伤模型系统（SCIMS）在损伤后 5 年的随访访谈，与 1 年的 SCIMS 结果相似，包括身体独立性、社会参与、生活满意度和抑郁症状的测量，以及居住地点、上学/工作出勤、再次住院和压疮的存在。
与 1 年的发现一致，患者特征仍然是损伤后 5 年结局的强有力预测因素，尽管有几个变量增加了一些结局的预测。物理治疗和治疗性娱乐的时间增加是 1 年结局的积极预测因素，而在 5 年时则不太准确。与心理学和社会工作/案例管理相关的更多时间预示着损伤后 5 年的抑郁症状更为严重。临床医生经验的增加是 1 年和 5 年的预测因素，尽管相关的积极结果在不同年份有所不同。
