Article

Retrospective cohort.Objectives :To estimate the association between
the Functional Independence Measure (FIM) for spinal cord injury (SCI) patients
at time of discharge from rehabilitation and long-term resource utilization,
residential status and employment. The intention was to assess the value of FIM
for projecting economic burden in SCI.Setting:Federally designated spinal cord
injury model system facilities throughout the USA.Methods:We analyzed data from
the National Spinal Cord Injury Statistical Center database (n=14 620)
(1988-2010), excluding subjects with: age <6 years, normal motor function, death
before discharge or etiology from gunshot or penetrating wound (n=11685
retained). We investigated the association between motor FIM at rehabilitation
discharge and residential status, survival and outcomes at 1, 5, 10, 15 and 20
years follow-up, including FIM, residential status, hospitalizations, days
hospitalized in previous year, daily paid and total care and paid hours worked.
Regression controlled for injury completeness, neurological level, demographic
characteristics and temporal effects.Results:All outcomes were statistically
associated with higher FIM scores at discharge. Each one-point increment in FIM
was associated with improvements in: probability of institution care at discharge
(-0.34%) and at follow-up (-0.13%), FIM score at follow-up (0.76 points),
hospitalizations and days hospitalized/year (-0.0044 and -0.071, respectively),
probability of needing paid assistance (-0.72%) or any assistance (-0.85%) and
probability of paid work (0.41%).Conclusion:The FIM at discharge has predictive
value for long-term outcomes. Improvement in FIM suggests reduced economic burden
in SCI patients.Sponsorship:Novartis Pharmaceuticals Corporation.

Langue : ANGLAIS