Article

OBJECTIVES: To investigate frequency of and reasons for readmission to acute care
(RTAC) during inpatient rehabilitation after traumatic spinal cord injury (SCI),
and to identify factors associated with RTAC. DESIGN: Prospective observational
cohort. SETTING: Inpatient rehabilitation. PARTICIPANTS: Individuals with SCI
(N=1376) consecutively admitted for inpatient rehabilitation; 1032 randomly
selected for model development; 344 selected for model cross-validation.
INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: RTAC, RTAC reasons,
rehabilitation length of stay (LOS), discharge location and FIM,
rehospitalization between discharge and year 1, and 1-year outcomes: FIM, Craig
Handicap Assessment and Reporting Technique, and Patient Health Questionnaire-9.
RESULTS: Participants (n=116; 11%) experienced RTAC with a total 143 episodes--96
patients experienced only 1 RTAC, while 14 had 2 RTACs, 5 had 3 RTACs, and 1 had
4 RTACs. The most common RTAC reasons were surgery (36%), infection (22%),
noninfectious respiratory (14%), and gastrointestinal (8%). Mean days +/- SD from
rehabilitation admission to first RTAC was 27 +/- 30 days. Seventy-four (7%)
patients had at least 1 RTAC for medical reasons and 46 (4%) for surgical
reasons. Regression analyses indicated several variables were associated with
RTACs: greater admission medical severity, lower admission cognitive FIM,
pressure ulcer acquired in acute care, and study site. Medical RTACs were
associated with higher body mass index, lower admission cognitive and motor FIM,
payer, and study site. Predictors of surgical RTAC were longer time from injury
to rehabilitation admission and study site. After controlling for the other
variables, the only outcome RTAC influenced was longer rehabilitation LOS.
CONCLUSIONS: Approximately 11% of SCI patients experience RTAC during the course
of rehabilitation for a variety of medical and surgical reasons. RTACs are
associated with longer rehabilitation LOS.
CI - Copyright (c) 2013 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS