Abstract
Study design
Prospective cohort study of the Thai Spinal Cord Injury Registry.
Objective
To determine whether being admitted to a spinal cord injury (SCI) specialized rehabilitation facility (SSRF) is associated with better functional outcomes.
Setting
Four rehabilitation facilities in Thailand; one a SSRF and the others non-SSRFs.
Methods
Data from the one SSRF and three non-SSRFs were extracted from the Thai Spinal Cord Injury Registry. Multivariate regression analysis was used to exclude the effect of confounding factors and prove the independent association of SSRF admission with respect to Spinal Cord Independence Measurement (SCIM) at discharge.
Results
Among the 234 new SCI inpatients enrolled, 167 persons (71%) had been admitted to the SSRF. The SSRF had a greater proportion of persons with AIS A, B, C tetraplegia and people with AIS D, whereas the non-SSRFs had a higher proportion of patients with AIS A, B or C paraplegia. Patients discharged from the SSRF demonstrated a greater SCIM score improvement than those from the non-SSRFs (24.1 vs 17.0; p = 0.003). By using multivariate regression analysis controlling for age, time from injury to rehabilitation, severity of injury and SCIM score on admission, SSRF admission was found to be an independent predictive factor of SCIM score improvement at discharge (p = 0.008).
Conclusion
Admission to an SSRF is associated with better rehabilitation outcomes. This finding supports the importance of SSRF access to improve the functional outcome of patients with SCI.
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Acknowledgements
We would like to thank Faculty of Medicine Chiang Mai University, Sirindhorn National Medical Rehabilitation Institute, Ratchaburi Hospital and Faculty of Medicine Siriraj Hospital Mahidol University for supporting data collections of this study.
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SP was responsible for designing the research question, collecting and analyzing the data, drafting the manuscript and writing the final version of the manuscript. NK, RM, CC, and PK were responsible for designing the research question, collecting the data and commenting on the final version of the manuscript. AK was responsible for designing the research question, collecting and analyzing the data and commenting on the final version of the manuscript.
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The study protocol was approved by the Institutional Ethics Committee of the Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand and was in accordance with the current version of the Helsinki Declaration. The research ID is 2880 and the study code is REH-2558–02880. The study was also approved by the local Ethics Committee of Sirindhorn National Medical Rehabilitation Institute, Ratchaburi Hospital and Faculty of Medicine Siriraj Hospital Mahidol University. We certify that all applicable institutional and governmental regulations concerning the ethical use of human volunteers were followed during all course of this study.
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Pattanakuhar, S., Kammuang-lue, P., Kovindha, A. et al. Is admission to an SCI specialized rehabilitation facility associated with better functional outcomes? Analysis of data from the Thai Spinal Cord Injury Registry. Spinal Cord 57, 684–691 (2019). https://doi.org/10.1038/s41393-019-0267-3
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DOI: https://doi.org/10.1038/s41393-019-0267-3
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