Article

OBJECTIVE: To compare patient and injury characteristics, rehabilitation
services, and outcomes between people incurring traumatic spinal cord injury
(SCI) at younger and older ages. DESIGN: Multisite prospective observational
cohort study. SETTING: Six acute rehabilitation facilities. PARTICIPANTS:
Patients (N=866) aged >/= 16 years admitted to participating centers for their
initial rehabilitation after SCI.
MAIN OUTCOME MEASURES: Motor FIM scores at discharge and 1 year postinjury, discharge
location, and postacute clinical pathways. RESULTS: Patients were divided into 4
age-at-injury groups: 16 to 29, 30 to 44, 45 to 60, and >60 years of age. Older
adults (>60 y) incurring SCI were more likely to be married, retired/unemployed,
on Medicare, and to have attained more education. Their injuries mostly resulted
from falls and were incomplete in nature. The oldest group had the highest
severity of illness, lowest admission and discharge motor FIM scores, and longer
rehabilitation stay. They received relatively less rehabilitation than younger
groups. They spent proportionately more time in occupational therapy working on
preparatory activities and less time on self-care activities during inpatient
rehabilitation. In the aged >60 years group, 80% went home at discharge; 17.2%
were discharged to a nursing home. Younger groups were less likely to go to a
nursing home. Admission motor FIM was the most significant predictor of motor FIM
at discharge and 1-year anniversary across age groups. But the age groups
differed significantly in patient and treatment factors that explained their
respective outcomes. CONCLUSIONS: Older injured individuals experienced a
different clinical pathway from younger patients. The present study suggests the
need for development of a rehabilitation program tailored specifically to older
adults.
CI - Copyright (c) 2013 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS