AGE AT ONSET OF SPINAL CORD INJURY IS ASSOCIATED WITH INCREASED INPATIENT CARE NEEDS, REDUCED INDEPENDENCE AT DISCHARGE AND A HIGHER RISK OF INSTITUTIONALIZATION AFTER PRIMARY INPATIENT REHABILITATION

Journal of Rehabilitation Medicine, 2023 · DOI: 10.2340/jrm.v54.4468 · Published: January 1, 2023

Simple Explanation

The age at which people have a spinal cord injury is increasing, and there has been a shift from traumatic towards more non-traumatic causes, particularly at an advanced age. The aim of this study was to determine the influence of age at onset of spinal cord injury on the inpatient rehabilitation process and on independence at discharge. Older age was associated with reduced independence at discharge and increased the risk of institutionalization after discharge.

Study Duration

2017 to 2019

Participants

250 patients with a newly acquired traumatic or non-traumatic spinal cord injury

Evidence Level

Retrospective cohort study

Key Findings

1
Chronological age predicted hours of nursing care and independence at discharge, was a significant risk factor for institutionalization, and correlated with the number of co-morbidities and secondary complications.
2
Length of stay and daily therapy hours were found to be age-independent.
3
Older patients had significantly more co-morbidities at admission than younger individuals.

Research Summary

This study aimed to describe patient characteristics and key features of the primary rehabilitation stay of people with a newly acquired SCI undergoing inpatient rehabilitation in a Swiss SCI specialized clinic, as well as the influence of age on inpatient rehabilitation parameters The main findings were that chronological age predicted hours of nursing care and independence at discharge, was a significant risk factor for institutionalization, and correlated with the number of co-morbidities and secondary complications. Taking the findings of the current study into consideration within a multidisciplinary case management may facilitate the organization of the primary inpatient rehabilitation process and, consequently, impact on rehabilitation outcomes.

Practical Implications

Tailored Rehabilitation Programs

Individually tailored multidisciplinary rehabilitation programmes may be beneficial for older individuals to achieve their full recovery potential.

Nursing Care

Increased awareness of the need for additional nursing care for older patients with SCI to improve rehabilitation outcomes.

Co-morbidity Management

Training healthcare professionals to screen for relevant co-morbidities at admission and to focus on prevention of secondary complications, especially in the older SCI population, could improve patient outcomes.

Study Limitations

1
Retrospective design
2
Chart review restricted to a predefined list of co-morbidities and secondary complications
3
Use of the SCIM III assessment is not yet established worldwide

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