Article

OBJECTIVE: To identify changes in hospitalizations, days hospitalized, nonroutine
physician visits, and self-reported fitness over 4 measurements separated by 4-
to 5-year intervals among participants with spinal cord injury (SCI), while
testing for the effects of age, time since injury, and age at injury onset.
DESIGN: A mixed model was used to analyze the cross-sequential data that include
cross-sectional and longitudinal elements. The data were collected in 1993, 1998,
2003, and 2008. SETTING: Data were collected at 2 Midwestern hospitals and a
Southeastern specialty hospital in the United States. PARTICIPANTS: Adult
participants (N=1032) with SCI of at least 1-year duration who participated
during at least 1 of 4 times of measurement dating back to 1993. Of these, 463
participated on all 4 occasions. INTERVENTIONS: Not applicable. MAIN OUTCOME
MEASURES: The outcome measures were 3 indicators of medical
treatments-hospitalization, days hospitalized, and nonroutine physician visits. A
fourth outcome was self-reported fitness. RESULTS: Results of the growth model
indicated some limited cohort effects for chronologic age, years since injury,
and age at injury onset at baseline. However, significant time effects were
observed for each of the health indices, with hospitalizations and physician
visits increasing and self-reported fitness decreasing. Significant cohort by
time interactions were observed for both number of hospitalizations and days
hospitalized with years postinjury and chronologic age. CONCLUSIONS: The natural
course of change in the health indices was in the direction of a greater need for
treatment and reduced fitness over time. Aging effects, as defined by cohort by
time interactions, indicated the greater need for hospitalization increased over
time at a greater rate for those with more years postinjury and of older ages.
CI - Copyright (c) 2013 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS