Article

OBJECTIVE: Acute spinal cord injury (SCI) centers aim to optimize outcome
following SCI. However, there is no timeframe to transfer patients from regional
to SCI centers in order to promote cost-efficiency of acute care. Our objective
was to compare costs and length of stay (LOS) following early and late transfer
to the SCI center. DESIGN: A retrospective cohort study involving 116 individuals
was conducted. Group 1 (n = 87) was managed in an SCI center promptly after the
trauma, whereas group 2 (n = 29) was transferred to the SCI center only after
surgery. Direct comparison and multivariate linear regression analyses were used
to assess the relationship between costs, LOS, and timing to transfer to the SCI
center. RESULTS: Length of stay was significantly longer for group 2 (median,
93.0 days) as compared with group 1 (median, 40.0 days; P < 10), and average
costs were also higher (median, Canadian $17,920.0 vs. $10,521.6; P = 0.004) for
group 2, despite similar characteristics. Late transfer to the SCI center was the
main predictive factor of longer LOS and increased costs. CONCLUSIONS: Early
admission to the SCI center was associated with shorter LOS and lower costs for
patients sustaining tetraplegia. Early referral to an SCI center before surgery
could lower the financial burden for the health care system. TO CLAIM CME
CREDITS: Complete the self-assessment activity and evaluation online at
http://www.physiatry.org/JournalCME CME OBJECTIVES: Upon completion of this
article, the reader should be able to: (1) Determine the optimal timing for
transfer of individuals with cervical traumatic spinal cord injury (SCI) in order
to decrease acute care resource utilization; (2) Determine benefits of a complete
perioperative management in a specialized SCI center; and (3) Identify factors
that may influence resource utilization for acute care following motor-complete
tetraplegia. LEVEL: Advanced ACCREDITATION: The Association of Academic
Physiatrists is accredited by the Accreditation Council for Continuing Medical
Education to provide continuing medical education for physicians.The Association
of Academic Physiatrists designates this activity for a maximum of 1.5 AMA PRA
Category 1 Credit(s). Physicians should only claim credit commensurate with the
extent of their participation in the activity.

Langue : ANGLAIS