Objective

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.

Design

Observational study using Practice-Based Evidence research methodology in which clinicians documented treatment details. Regression modeling was used to predict outcomes.

Setting

Five inpatient SCI rehabilitation centers in the US.

Participants

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 Measures

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.

Results

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.

Conclusion

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.

中文翻译：

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患者特征和住院康复服务与脊髓损伤后 5 年结果的关系：SCIRehab 项目的后续行动

 客观的

旨在检查住院脊髓损伤 (SCI) 康复期间患者特征和治疗量与损伤后 5 年结果的关联，并将其与损伤后 1 年发现的关联进行比较。

 设计

使用基于实践的证据研究方法的观察性研究，其中临床医生记录了治疗细节。回归模型用于预测结果。

 环境

美国有五个住院 SCI 康复中心。

 参加者

参与者为 792 名 SCIRehab 参与者，年龄为> 12 岁，签署了知情同意书，并完成了 1 年和 5 年伤后访谈。

 结果衡量

结果数据来自脊髓损伤模型系统 (SCIMS) 受伤后 5 年的随访访谈，与 1 年 SCIMS 结果类似，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、学校/工作出勤情况、再住院情况以及是否存在压疮。

 结果

与一年的研究结果一致，尽管有几个变量增加了对某些结果的预测，但患者特征仍然是损伤后 5 年结果的有力预测因素。更多时间进行物理治疗和治疗性娱乐是 1 年结果的积极预测因素，但在 5 年结果中则不太正确。花在心理学和社会工作/病例管理上的时间越多，预示着受伤后 5 年抑郁症状会更严重。尽管相关的积极结果因年份而异，但更多的临床医生经验是 1 年和 5 年的预测因素。

 结论

受伤后 5 年的各种结果主要由受伤前和受伤后的特征来解释，住院康复期间接受的治疗数量几乎没有提供额外的差异。