Original researchInternational Retrospective Comparison of Inpatient Rehabilitation for Patients With Spinal Cord Dysfunction: Differences According to Etiology
Section snippets
Setting and study design
A retrospective open-cohort case series was conducted of consecutive patients with spinal cord dysfunction admitted for initial inpatient rehabilitation in an SRU between January 1, 2008, and December 31, 2010. This was an international study with 1 SRU in each of 9 countries (Australia, Canada, Italy, India, Ireland, The Netherlands, Switzerland, United Kingdom, United States). Details of the organization of rehabilitation services and perceived barriers to admission and discharge within the
Results
There were 956 eligible patients admitted into the 9 SRUs over the study period. As previously reported, the median age on admission to the SRU was 59 years (IQR, 46–70y; range, 18–97y), and most patients were men (n=581, 60.8%) and had a paraplegic level of injury (n=691, 72.3%).11 The SRU in the United States contributed almost 30% of the cases in the total sample. The median LOS in the SRU was 46.5 days (IQR, 17–89.5d).
There was a diverse range of etiologies.11 These included degenerative
Discussion
There were major differences in the epidemiologic characteristics and clinical outcomes in patients with different etiologies of spinal cord dysfunction. Our study facilitates comparisons regarding the most common etiologies of spinal cord dysfunction between a diverse range of countries and health systems. These comparisons have been difficult to make previously. Clearly, local conditions impact the etiology of spinal cord dysfunction, including referral patterns11, 14; however, our project
Conclusions
This international study of spinal cord dysfunction showed important variation between the different etiologies in demographic and clinical characteristics. Further research, including multiple centers within each country, is required to distinguish country effects from center effects. Our findings also show the potential of using uniform data collection across SRUs in different countries to make detailed comparisons across settings possible. It is believed that adopting the International SCI
Acknowledgments
We thank the following people for assistance with facilitating the data collection: Bianca Fedele, BA(Hons) (Caulfield Hospital and Epworth-Monash Rehabilitation Medicine Unit, Melbourne, Australia); Grace Li, MD (GF Strong Rehabilitation Center, Canada); Michael Baumberger, MD (Swiss Paraplegic Center, Switzerland); Joost van Middendorp, MD, PhD, and Salman Lari, MBBS, MRCS (National Spinal Injuries Center, Stoke Mandeville Hospital, UK); Jolien Vervoordeldonk, MD, and Floris van Asbeck, MD,
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Disclosures: none.