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J Neurotrauma. 2017 Oct 15;34(20):2867-2876. doi: 10.1089/neu.2016.4930. Epub 2017 May 24.

Does Specialized Inpatient Rehabilitation Affect Whether or Not People with Traumatic Spinal Cord Injury Return Home?

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1 Rick Hansen Institute , Vancouver, British Columbia, Canada .
2 Physical Medicine and Rehabilitation, Dalhousie University , Fredericton, New Brunswick, Canada .
3 Physical Medicine and Rehabilitation, University of Saskatchewan , Saskatoon, Saskatchewan, Canada .
4 Division of Physical Medicine and Rehabilitation, Department of Clinical Neurosciences, University of Calgary , Foothills Hospital, Calgary, Alberta, Canada .
5 Department of Medicine, Dalhousie University , Nova Scotia Rehabilitation Centre, Halifax, Nova Scotia, Canada .
6 Department of Medicine, University of Manitoba , Winnipeg, Manitoba, Canada .
7 Glenrose Rehabilitation Hospital, University of Alberta , Edmonton, Alberta, Canada .
8 Neurosurgery, CHU de Québec; Department of Surgery, Université Laval , Québec, Canada .


Return to living at home is an important patient-reported outcome following traumatic spinal cord injury (tSCI). Specialized inpatient rehabilitation assists such patients in maximizing function and independence. Our project aim was to describe those patients receiving specialized rehabilitation after tSCI in Canada, and to determine if such rehabilitation improved the likelihood of returning home. This cohort study utilized data from the Rick Hansen Spinal Cord Injury Registry (RHSCIR) to identify patients with tSCI discharged from 1 of 18 participating acute specialized spine facilities between 2011 and 2015 to either 1 of 13 participating specialized rehabilitation facilities, or to another discharge destination. To determine if specialized rehabilitation affected likelihood of returning home, multiple logistic regressions and propensity score matchings were performed to account for age at injury, gender, neurological severity and level, acute length of stay (LOS), and region of residence. The χ2 test was used to compare rate of return home between matched groups. Of the 1599 patients included, 71% received specialized rehabilitation. Receiving specialized rehabilitation was a significant and strong predictor of return to home after controlling for covariates (adjusted odds ratio = 3.1; 95% confidence interval [CI], 1.6-5.9). The rate of return to home was significantly higher in the matched rehabilitation group than the no rehabilitation group (98% vs. 87%, p = 0.0004). For the matched patients, an extra 11 patients returned home for every 100 patients receiving specialized rehabilitation. However, effect of age on returning home requires further investigation. Improving access to specialized rehabilitation could potentially reduce discharges to nursing homes or other non-home destinations.


discharge destination; home; quality of life; specialized rehabilitation; spinal cord injury


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