Factors Affecting Home Discharge of Older Adults with Cervical Spinal Cord Injury in Japan Regional Population

Spine Surg Relat Res, 2023 · DOI: 10.22603/ssrr.2023-0045 · Published: June 9, 2023

Simple Explanation

This study examines factors influencing whether older Japanese adults with cervical spinal cord injuries (CSCI) are discharged to their homes versus other facilities. The study found that older age, living alone, severe injury level, and complete injury status at admission were key factors preventing home discharge. Understanding these factors can help healthcare providers set realistic discharge goals early in treatment for older CSCI patients.

Study Duration

2005-2020

Participants

219 patients over 65 years old with cervical spinal cord injury

Evidence Level

Not specified

Key Findings

1
More than half of older adults with CSCI were discharged to places other than their own home.
2
Old age at injury (over 75 years), living alone, a high level of injury (C1-4), and complete injury (AIS: A) at admission were independent factors influencing home discharge.
3
Patients with complete injuries at the initial consultation should not abandon the goal of home discharge, as some in the study were successfully discharged home.

Research Summary

This retrospective cohort study investigated factors influencing home discharge in older adults with cervical spinal cord injury (CSCI) in Japan. The study identified old age, living alone, high level of injury, and complete injury at admission as independent factors that negatively influenced home discharge. The findings suggest that healthcare providers should consider these factors when setting discharge goals for older CSCI patients and that even patients with complete injuries should not be ruled out for home discharge.

Practical Implications

Realistic Goal Setting

Healthcare providers can use these findings to set more realistic discharge goals for older adults with CSCI early in the treatment process.

Targeted Interventions

Interventions can be targeted to address factors like living alone and to optimize rehabilitation for patients with severe injuries.

Optimistic Rehabilitation

Even patients with complete injuries at admission should be given the opportunity for rehabilitation with the goal of home discharge in mind.

Study Limitations

1
The study did not consider environmental factors such as housing situation and insurance.
2
The analysis did not examine the impact of pressure ulcers or internal medical complications.
3
The study is limited to a single hospital in Japan, which may limit the generalizability of the findings.

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