(Scientific Session) Determinants of Discharge Destination After Inpatient Rehabilitation for Nontraumatic Spinal Cord Injury Patients: A Single-Center Retrospective Review

Background and/or Objectives: Patients diagnosed with spinal cord injury represent an important population often requiring acute rehabilitation services within an inpatient rehabilitation facility (IRF). Prior studies investigated various factors associated with discharge disposition for traumatic spinal cord injury patients. However, there is a relative scarcity of related literature for nontraumatic spinal cord injury (NTSCI) patients. The aim of this study is to identify important determinants of discharge with the intent of using them to establish appropriate rehabilitation goals and expectations for NTSCI patients who are admitted to an IRF.

Design: This is a retrospective cohort study with data obtained from the patients’ electronic medical records. The variables analyzed include sex, age, body mass index (BMI), acute care length of stay (LOS), IRF LOS, injury type, injury level, Charlson Comorbidity Index (CCI) score, and insurance provider (Medicare vs other).

Setting: Single IRF within a Tertiary-Care University Hospital

Participants: The study population consisted of 249 patients aged 18 years or older who were admitted to an IRF with an appropriate NTSCI diagnosis and documented GG mobility scores upon admission.

Interventions: Logistic regression analysis.

Main Outcome Measures: Direct discharge home or to a skilled nursing facility (SNF).

Results: The adjusted logistic regression model did reveal that age and BMI were significantly associated with discharge destination. For each additional 10 years in age and 1-unit increase in BMI, the odds that a patient is discharged to SNF instead of home is about 1.78 (p = 0.0051) and 1.09 (p = 0.0020) times higher, respectively. No significant difference in the odds of discharge to SNF compared to discharge home was found for the remainder of the variables.

Conclusions: Making physiatrists aware of the variables that are associated with discharge destination following an IRF admission will assist in establishing appropriate rehabilitation goals and expectations in this patient population with the ultimate goal of enhancing patients for community reintegration.