The Uniform Data System for Medical Rehabilitation Report of Patients with Traumatic Spinal Cord Injury Discharged from Rehabilitation Programs in 2002-2010

Granger CV, Karmarkar AM, Graham JE, Deutsch A, Niewczyk P, DiVita MA, Ottenbacher KJ: The uniform data system for medical rehabilitation: report of patients with traumatic spinal cord injury discharged from rehabilitation programs in 2002Y2010. Am J Phys Med Rehabil 2012; 91: 289Y299. Objective: This study aimed to provide benchmarking information from a large national sample of patients receiving inpatient rehabilitation after a traumatic spinal cord injury. Design: This was an analysis of secondary data from 891 inpatient medical rehabilitation facilities in the United States that contributed traumatic spinal cord injury data to the Uniform Data System for Medical Rehabilitation from January 2002 to December 2010. Variables analyzed included demographic information (age, sex, marital status, race/ ethnicity, prehospital living setting, discharge setting), hospitalization information (length of stay, program interruptions, payer, onset date, rehabilitation impairment group, International Classification of Diseases 9codes for admitting diagnosis, co-morbidities), and functional status (Functional Independence Measure [FIM] instrument ratings at admission and discharge, FIM efficiency, FIM gain). Results: The final sample included 47,153 patients with traumatic spinal cord injury. Overall, the mean length of stay was 26.2 +/- 23.2 days: yearly means ranged from 29.7 +/- 25.4 in 2002 to 22.9 +/- 18.9in 2009. FIM total admission and discharge ratings also declined during the 8-yr study period; admission decreased from 60.5 +/- 17.4 to 55.9 +/- 16.3; discharge decreased from 86.1 +/- 23.8 to 82.4 +/- 23.4. Rehabilitation efficiency (FIM gain per day) remained relatively stable over time (1.6 +/- 1.7 points per day). The percentage of all patients discharged to the community ranged from 75.8% to 71.5% per year. Wheelchair users stayed in rehabilitation longer than did persons who could walk (34.6 +/- 217.4 vs. 17.4 +/- 14.1 days) and also experienced less functional improvement (21.6 +/- 15.8 vs. 29.6 +/- 16.3 FIM points). Conclusions: National data from persons with traumatic spinal cord injury in 2002Y2010 indicate that lengths of stay declined, but efficiency in functional independence was stable to slightly increased. More than 70% of patients were consistently discharged to community settings after inpatient rehabilitation.