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2013 - 2018年住院康复机构收治的老年非创伤性脊髓损伤患者的特征及预后趋势

Trends in the characteristics and outcomes of older patients with non-traumatic spinal cord injury treated in inpatient rehabilitation facilities: 2013-2018.

作者信息

Deutsch Anne, Burns Jennifer, Potelle John, Kessler Allison

机构信息

Center for Rehabilitation Outcomes Research, Shirley Ryan AbilityLab, Chicago, Illinois, USA.

Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.

出版信息

J Spinal Cord Med. 2025 Sep;48(5):802-812. doi: 10.1080/10790268.2024.2335414. Epub 2024 Apr 8.

Abstract

OBJECTIVE

To describe the characteristics and outcomes of older (≥ 65 years of age) patients with a non-traumatic spinal cord injury (NTSCI) treated in inpatient rehabilitation facilities (IRFs) between 2013 and 2018.

DESIGN

Observational study.

SETTING

IRFs in the United States.

PARTICIPANTS

93,631 IRF Medicare stays for patients with NTSCI.

INTERVENTIONS

Not Applicable.

MAIN OUTCOME MEASURES

Length of stay, self-care and mobility function, discharge destination.

RESULTS

Between 2013 and 2018, the number of older (≥ 65 years of age) Medicare patients with a NTSCI treated in IRFs increased about 22.1 percent, from 14,149 to 17,275. In addition to the increase, patients' sociodemographic characteristics shifted to have a slightly higher percentage of patients aged 65-74 years, a slightly higher percentage of males, and slightly fewer patients who identified as Hispanic. There was also a trend of more patients in the higher acuity case-mix groups and comorbidities tiers, but the median length of stay remained 12 days across all years. The percent of patients discharged home or to a community-based setting varied from 73.7 to 75.2 without a trend, although discharge self-care and mobility function increased slightly across the years.

CONCLUSIONS

Between 2013 and 2018, the number of Medicare patients with NTSCI treated in IRFs increased by more than 22 percent. While patient complexity increased, the median length of stay remained 12 days across the years. Discharge self-care and mobility function increased slightly, and the percent of patients discharged home ranged from 73.7 to 75.2 across the years.

摘要

目的

描述2013年至2018年间在住院康复机构(IRF)接受治疗的老年(≥65岁)非创伤性脊髓损伤(NTSCI)患者的特征和治疗结果。

设计

观察性研究。

地点

美国的住院康复机构。

参与者

93631例因NTSCI入住IRF的医疗保险患者。

干预措施

不适用。

主要观察指标

住院时间、自我护理和移动功能、出院去向。

结果

2013年至2018年间,在IRF接受治疗的老年(≥65岁)医疗保险NTSCI患者数量增加了约22.1%,从14149例增至17275例。除了数量增加外,患者的社会人口学特征也发生了变化,65 - 74岁患者的比例略有上升,男性比例略有上升,而自称西班牙裔的患者略有减少。在病情较重的病例组合组和合并症层级中,患者数量也有增加的趋势,但所有年份的中位住院时间均为12天。出院回家或前往社区环境的患者比例在73.7%至75.2%之间波动,无明显趋势,不过多年来出院时的自我护理和移动功能略有改善。

结论

2013年至2018年间,在IRF接受治疗的医疗保险NTSCI患者数量增加了22%以上。虽然患者的病情复杂性增加,但多年来中位住院时间仍为12天。出院时的自我护理和移动功能略有改善,多年来出院回家的患者比例在73.7%至75.2%之间。

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本文引用的文献

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Characteristics and Outcomes of Medicare Patients Treated in Inpatient Rehabilitation Facilities: 2013-2018.
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