Effects of Gender on Inpatient Rehabilitation Outcomes in the Elderly With Incomplete Paraplegia From Nontraumatic Spinal Cord Injury

Abstract

Objective: To examine gender differences in rehabilitation outcomes for patients with nontraumatic spinal cord injury.Research Design: Secondary analysis was conducted on Medicare beneficiary data from 65 to 74 year olds with incomplete paraplegia discharged from inpatient rehabilitation facilities in 2002 through 2005. Main Outcome Measures: Length of stay, Functional Independence Measure instrument motor item and subscale scores on discharge, and discharge destination. Results: Among patients with degenerative spinal disease, men had significantly longer rehabilitation stays than women (P , 0.001). Men with degenerative spinal disease had significantly lower discharge Functional Independence Measure scores than women, indicating more dependence in self-care (P , 0.001) and mobility (P , 0.001). Among patients with degenerative spinal disease, men were less likely to walk (odds ratio 5 0.58; 95% CI 5 0.38-0.87) and less likely to be independent with bladder management (odds ratio 5 0.44; 95% CI 5 0.31-0.62). Among patients with vascular ischemia, men were more independent (B 5 2.59; 99% CI 5 0.42-4.76) in mobility than women. There were no gender differences in the malignant spinal tumors group. There were no gender differences in being discharged to a community-based residence. Conclusions: Gender distributions varied by etiology. Gender differences were found in demographics, length of stay, and functional outcomes but not discharge destination. Men were more dependent than women at discharge in the etiology group with the least overall disability (degenerative spinal disease) and more independent in mobility than women at discharge in the etiology group with the most overall disability (vascular ischemia).

Factors influencing home discharge after inpatient rehabilitation of older patients: a systematic review

“…Seven studies [ 22 – 28 ] had a score of at least 75 % (9 points or more) of the total possible score of 12. Another eight studies [ 7 , 9 , 10 , 29 – 33 ] scored 50–75 % (6 – 8 points) of the maximum score of 12, and three studies scored less than 6 points [ 14 , 34 , 35 ], which the authors of the present study considered of weak methodological quality.…”

“…Due to inconsistent results, the association between home discharge and gender [ 9 , 22 , 23 , 27 – 29 , 33 ], comorbidity [ 9 , 10 , 29 , 31 ], type of surgery [ 10 , 25 , 26 , 34 ], living alone [ 28 , 30 ] and postoperative complications [ 10 , 31 ] was less obvious. These opposing outcomes might have been caused by differences in study populations (traumatic brain injury [ 9 ], hip replacement [ 10 , 29 , 30 , 33 ], knee replacement [ 25 , 28 ], spinal cord injury [ 23 ] and lower extremity amputation [ 31 ]) or a difference in the size of the study population [ 36 ].…”

Rehabilitation for Spinal Cord Injury Caused by Thoracic Aortic Aneurysm

“…As shown in Table 12, we compared the gain in motor FIM during hospitalization and the rate of this gain with those in the reported databases. The independent patients at home had a mean gain in motor FIM of 37 points, and their rate of improvement was also very high ((gain of mFIM/LOS); 0.30 (0.17)) compared with those of the other patients, who had comparatively good outcomes for non-traumatic SCI patients (Kay et al, 2010;New & Epi, 2005;Yokoyama et al, 2006). Our series were obtained from an acute care hospital, and selected patients were transferred to tertiary rehabilitation centers.…”

“…They also suffered sacral decubitus due to deterioration of their general condition and long bed rest. In general, among elderly patients with vascular ischemic spinal cord injury, males were more independently mobile than females (Kay et al, 2010). In our series, our previously reported cases and seven recently rehabilitated patients; i.e., a total of 19 patients, were analyzed.…”

Analysis of the factor infulencing functional outcomes in patients with spinal cord injury

“…6 Peter и аутори су испитивали утицај пола и старости на функционални опоравак код особа са повредама кичмене мождине. 7 Putz и аутори су испитивали утицај политрауме на функционални опоравак особа са повредама кичмене мождине. 8 Многи аутори су испитивали функционални опоравак код трауматских и нетраумтских повреда кичмене мождине.…”