• Arch Phys Med Rehabil · Apr 2013

    Multicenter Study Comparative Study

    Comparing rehabilitation services and outcomes between older and younger people with spinal cord injury.

    • Ching-Hui Hsieh, Gerben DeJong, Suzanne Groah, Pamela H Ballard, Susan D Horn, and Wenqiang Tian.
    • Center for Post-acute Innovation & Research, MedStar National Rehabilitation Hospital, Washington, DC 20010, USA. Jean.Hsieh@medstar.net
    • Arch Phys Med Rehabil. 2013 Apr 1;94(4 Suppl):S175-86.

    ObjectiveTo compare patient and injury characteristics, rehabilitation services, and outcomes between people incurring traumatic spinal cord injury (SCI) at younger and older ages.DesignMultisite prospective observational cohort study.SettingSix acute rehabilitation facilities.ParticipantsPatients (N=866) aged ≥ 16 years admitted to participating centers for their initial rehabilitation after SCI.InterventionsNot applicable.Main Outcome MeasuresMotor FIM scores at discharge and 1 year postinjury, discharge location, and postacute clinical pathways.ResultsPatients were divided into 4 age-at-injury groups: 16 to 29, 30 to 44, 45 to 60, and >60 years of age. Older adults (>60 y) incurring SCI were more likely to be married, retired/unemployed, on Medicare, and to have attained more education. Their injuries mostly resulted from falls and were incomplete in nature. The oldest group had the highest severity of illness, lowest admission and discharge motor FIM scores, and longer rehabilitation stay. They received relatively less rehabilitation than younger groups. They spent proportionately more time in occupational therapy working on preparatory activities and less time on self-care activities during inpatient rehabilitation. In the aged >60 years group, 80% went home at discharge; 17.2% were discharged to a nursing home. Younger groups were less likely to go to a nursing home. Admission motor FIM was the most significant predictor of motor FIM at discharge and 1-year anniversary across age groups. But the age groups differed significantly in patient and treatment factors that explained their respective outcomes.ConclusionsOlder injured individuals experienced a different clinical pathway from younger patients. The present study suggests the need for development of a rehabilitation program tailored specifically to older adults.Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

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