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Predicting rehabilitation length of stay in Canada: It’s not just about impairment

INTRODUCTION: Current tertiary Spinal Cord Injury (SCI) rehabilitation funding and rehabilitation length of stay (R-LOS) in most North American jurisdictions are linked to an individual’s impairment. Our objectives were to: 1) describe the impact of relevant demographic, impairment and medical compl...

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Autores principales: Catharine Craven, B., Kurban, Dilnur, Farahani, Farnoosh, Rivers, Carly S., Ho, Chester, Linassi, A. Gary, Gagnon, Dany H., O'Connell, Colleen, Ethans, Karen, Bouyer, Laurent J., Noonan, Vanessa K.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Taylor & Francis 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5778931/
https://www.ncbi.nlm.nih.gov/pubmed/28899285
http://dx.doi.org/10.1080/10790268.2017.1368962
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author Catharine Craven, B.
Kurban, Dilnur
Farahani, Farnoosh
Rivers, Carly S.
Ho, Chester
Linassi, A. Gary
Gagnon, Dany H.
O'Connell, Colleen
Ethans, Karen
Bouyer, Laurent J.
Noonan, Vanessa K.
author_facet Catharine Craven, B.
Kurban, Dilnur
Farahani, Farnoosh
Rivers, Carly S.
Ho, Chester
Linassi, A. Gary
Gagnon, Dany H.
O'Connell, Colleen
Ethans, Karen
Bouyer, Laurent J.
Noonan, Vanessa K.
author_sort Catharine Craven, B.
collection PubMed
description INTRODUCTION: Current tertiary Spinal Cord Injury (SCI) rehabilitation funding and rehabilitation length of stay (R-LOS) in most North American jurisdictions are linked to an individual’s impairment. Our objectives were to: 1) describe the impact of relevant demographic, impairment and medical complexity variables at rehabilitation admission on R-LOS among adult Canadians with traumatic SCI; and 2) identify factors which extend R-LOS. METHODS: Data from 1,376 adults with traumatic SCI were obtained via chart abstraction and administrative data linkage from 15 Rick Hansen SCI Registry sites (2004–2014). Variables included age, sex, neurological impairment (level, severity), rehabilitation onset days, R-LOS, Glasgow Coma Score (GCS) at admission, prior ventilation or endotracheal tube (Vent/ETT), or indwelling bladder catheter at acute discharge, pain interference score, intensive care unit (ICU) length of stay (LOS), and lower extremity motor scores (LEMS) at rehabilitation admission. Variables related to R-LOS in bivariate analysis were included in multivariate analysis to determine their impact on R-LOS. RESULTS: Prior Vent/ETT tube, indwelling bladder catheter, GCS, LEMS, and neurological impairment were related to R-LOS in bivariate analysis. Multivariate linear regression analyses identified five variables as significant predictors: age, Vent/ETT for >24 hours in acute care, indwelling bladder catheter at acute discharge, LEMS, and NLI/AIS subgroup at rehabilitation admission explained 32% of the variation in R-LOS (p<0.001). CONCLUSIONS: Based on the enclosed formula, and knowledge of an individual’s age at injury, spinal cord impairment (level and severity), prior Vent/ETT, presence of an indwelling bladder catheter, and LEMS at admission, administrators and clinicians may readily identify patients for whom an extended R-LOS beyond conventional LOS targets is likely.
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spelling pubmed-57789312018-11-01 Predicting rehabilitation length of stay in Canada: It’s not just about impairment Catharine Craven, B. Kurban, Dilnur Farahani, Farnoosh Rivers, Carly S. Ho, Chester Linassi, A. Gary Gagnon, Dany H. O'Connell, Colleen Ethans, Karen Bouyer, Laurent J. Noonan, Vanessa K. J Spinal Cord Med Research Articles INTRODUCTION: Current tertiary Spinal Cord Injury (SCI) rehabilitation funding and rehabilitation length of stay (R-LOS) in most North American jurisdictions are linked to an individual’s impairment. Our objectives were to: 1) describe the impact of relevant demographic, impairment and medical complexity variables at rehabilitation admission on R-LOS among adult Canadians with traumatic SCI; and 2) identify factors which extend R-LOS. METHODS: Data from 1,376 adults with traumatic SCI were obtained via chart abstraction and administrative data linkage from 15 Rick Hansen SCI Registry sites (2004–2014). Variables included age, sex, neurological impairment (level, severity), rehabilitation onset days, R-LOS, Glasgow Coma Score (GCS) at admission, prior ventilation or endotracheal tube (Vent/ETT), or indwelling bladder catheter at acute discharge, pain interference score, intensive care unit (ICU) length of stay (LOS), and lower extremity motor scores (LEMS) at rehabilitation admission. Variables related to R-LOS in bivariate analysis were included in multivariate analysis to determine their impact on R-LOS. RESULTS: Prior Vent/ETT tube, indwelling bladder catheter, GCS, LEMS, and neurological impairment were related to R-LOS in bivariate analysis. Multivariate linear regression analyses identified five variables as significant predictors: age, Vent/ETT for >24 hours in acute care, indwelling bladder catheter at acute discharge, LEMS, and NLI/AIS subgroup at rehabilitation admission explained 32% of the variation in R-LOS (p<0.001). CONCLUSIONS: Based on the enclosed formula, and knowledge of an individual’s age at injury, spinal cord impairment (level and severity), prior Vent/ETT, presence of an indwelling bladder catheter, and LEMS at admission, administrators and clinicians may readily identify patients for whom an extended R-LOS beyond conventional LOS targets is likely. Taylor & Francis 2017-11 2017-09-12 /pmc/articles/PMC5778931/ /pubmed/28899285 http://dx.doi.org/10.1080/10790268.2017.1368962 Text en © The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited, and is not altered, transformed, or built upon in any way.
spellingShingle Research Articles
Catharine Craven, B.
Kurban, Dilnur
Farahani, Farnoosh
Rivers, Carly S.
Ho, Chester
Linassi, A. Gary
Gagnon, Dany H.
O'Connell, Colleen
Ethans, Karen
Bouyer, Laurent J.
Noonan, Vanessa K.
Predicting rehabilitation length of stay in Canada: It’s not just about impairment
title Predicting rehabilitation length of stay in Canada: It’s not just about impairment
title_full Predicting rehabilitation length of stay in Canada: It’s not just about impairment
title_fullStr Predicting rehabilitation length of stay in Canada: It’s not just about impairment
title_full_unstemmed Predicting rehabilitation length of stay in Canada: It’s not just about impairment
title_short Predicting rehabilitation length of stay in Canada: It’s not just about impairment
title_sort predicting rehabilitation length of stay in canada: it’s not just about impairment
topic Research Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5778931/
https://www.ncbi.nlm.nih.gov/pubmed/28899285
http://dx.doi.org/10.1080/10790268.2017.1368962
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