Association between time to rehabilitation and outcomes after spinal cord injury

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Study examined the relationship between time to rehabilitation after spinal cord injury (SCI) and rehabilitation outcomes at discharge and 1-year postinjury. Participants were 3,937 patients who experienced traumatic SCI between 2000 and 2014, were 18 years or older, and were admitted to a Spinal Cord Injury Model Systems center within 24 hours of injury. Time to rehabilitation was measured as the number of days between the injury and admission to inpatient rehabilitation. Outcome measures included the Rasch-transformed Functional Independence Measure (FIM) motor score at discharge and 1-year postinjury, discharge to a private residence, and the Craig Handicap Assessment and Reporting Technique (CHART) Physical Independence and Mobility scores at 1-year postinjury. After accounting for health status, a 10-percent increase in time to rehabilitation was associated with a 1.50 lower FIM motor score at discharge and a 3.92 lower CHART Physical Independence score at 1-year postinjury. Compared to the mean FIM motor score (37.5) and mean CHART Physical Independence score (74.7), the above-mentioned values represent relative declines of 4.0 percent and 5.3 percent, respectively. There was no association between time to rehabilitation and discharge to a private residence, 1-year FIM motor score, or the CHART mobility score. Findings suggest that earlier rehabilitation after traumatic SCI may improve patients’ functional status at discharge.

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