Franceschini Marco, Thouant Carrie-Louise, Agosti Maurizio, Gimigliano Francesca, Ferro Salvatore, Bonavita Jacopo, Pagliacci Maria C, Felzani Giorgio, Pournajaf Sanaz
Research Area in Neuromotor Rehabilitation and Rehabilitation Robotics, Department of Neuroscience, IRCCS San Raffaele Roma, Rome, Italy.
Research Area in Neuromotor Rehabilitation and Rehabilitation Robotics, Department of Neuroscience, IRCCS San Raffaele Roma, Rome, Italy -
Eur J Phys Rehabil Med. 2025 Jun;61(3):482-495. doi: 10.23736/S1973-9087.25.08777-5. Epub 2025 Jul 11.
Non-traumatic spinal cord injuries (NTSCI) represent an increasing public health concern, particularly in aging populations, yet there is limited literature on rehabilitation outcomes and key predictors of home discharge in this population.
This study evaluates the impact of demographic and clinical characteristics on rehabilitation outcomes and home discharge rates in individuals with NTSCI.
Prospective observational cohort study.
Thirty-one specialized SCI centers in 13 Italian regions.
Individuals with NTSCI.
Demographic and clinical characteristics of 394 rehabilitation were recorded at admission (T1) and discharge (T2). The American Spinal Injury Association (ASIA) Scale and Spinal Cord Independence Measure (SCIM) were used to assess motor function and functional independence. Binary logistic regression was employed to develop a predictive model for home discharge, incorporating categorical and continuous variables. Two common metrics for this purpose are the Akaike Information Criterion (AIC) and the Bayesian Information Criterion (BIC). Predictive factors for home discharge were analyzed using logistic regression and ROC curves.
80% of participants were discharged home. Key predictors of home discharge included higher SCIM scores, younger age, and being married. The SCIM score at discharge was a stronger predictor of home discharge than at admission. Length of stay (LOS) was also a significant factor, with longer stays associated with better functional outcomes, particularly in individuals with severe impairments.
SCIM scores at discharge, age, and marital status emerged as key predictors of home discharge, highlighting the importance of personalized rehabilitation strategies and structured discharge planning. Tailoring rehabilitation programs to maximize SCIM score improvements may enhance home discharge rates and long-term patient outcomes.
This study emphasizes the importance of continuous functional assessment using SCIM during rehabilitation, allowing clinicians to optimize treatment plans and improve home discharge likelihood. Additionally, considering demographic factors such as age and marital status in discharge planning may facilitate better reintegration into home environments. Longer rehabilitation stays for individuals with more severe injuries (ASIA A/B) can significantly enhance outcomes. By incorporating these predictors into everyday practice, rehabilitation clinics can better optimize patient care, increase home discharge rates, and improve overall quality of life post-rehabilitation.
非创伤性脊髓损伤（NTSCI）日益引起公众健康关注，尤其是在老年人群中，但关于该人群康复结局及家庭出院关键预测因素的文献有限。
本研究评估人口统计学和临床特征对NTSCI患者康复结局及家庭出院率的影响。
前瞻性观察队列研究。
意大利13个地区的31个专业脊髓损伤中心。
NTSCI患者。
记录394例康复患者入院时（T1）和出院时（T2）的人口统计学和临床特征。采用美国脊髓损伤协会（ASIA）量表和脊髓独立测量量表（SCIM）评估运动功能和功能独立性。采用二元逻辑回归建立家庭出院预测模型，纳入分类变量和连续变量。为此目的的两个常用指标是赤池信息准则（AIC）和贝叶斯信息准则（BIC）。使用逻辑回归和ROC曲线分析家庭出院的预测因素。
80%的参与者出院回家。家庭出院的关键预测因素包括较高的SCIM评分、较年轻的年龄和已婚。出院时的SCIM评分比入院时更能预测家庭出院。住院时间（LOS）也是一个重要因素，住院时间越长，功能结局越好，尤其是在严重损伤的个体中。
出院时的SCIM评分、年龄和婚姻状况是家庭出院的关键预测因素，突出了个性化康复策略和结构化出院计划的重要性。调整康复计划以最大限度提高SCIM评分可能会提高家庭出院率和患者长期结局。
本研究强调在康复期间使用SCIM进行持续功能评估的重要性，使临床医生能够优化治疗计划并提高家庭出院可能性。此外，在出院计划中考虑年龄和婚姻状况等人口统计学因素可能有助于更好地重新融入家庭环境。对于伤势较重（ASIA A/B）的个体，延长康复住院时间可显著改善结局。通过将这些预测因素纳入日常实践，康复诊所可以更好地优化患者护理，提高家庭出院率，并改善康复后的总体生活质量。
