Comparison of patients managed in specialised spinal rehabilitation units with those managed in non-specialised rehabilitation units

Study design: Prospective open cohort study. Objective: Compare the demographic characteristics and rehabilitation outcomes for both non-traumatic SCI (NT-SCI) and traumatic SCI (T-SCI) patients admitted into either specialist spinal cord injury rehabilitation units (SCIRUs) or non-specialist rehabilitation units (NSRUs). Setting: Rehabilitation units in Australia. Methods: The Australasian Rehabilitation Outcomes Centre maintains a national database on inpatients admitted to most (130/145) public and private rehabilitation units in Australia. Patients were included if they had a diagnosis of spinal cord injury (SCI) and were discharged between 1 January 2006 and 31 December 2006. Patients were excluded if admitted for <7 days, only for assessment, or were a readmission following a previous SCI. Results: There were 668 patients with confirmed SCI admitted (NT-SCI n = 361, 54.0%; T-SCI n = 307, 46.0%). NT-SCI patients were much less likely to be admitted into a specialist SCIRU (30.5%) compared with T-SCI patients (70.4%). For both NT-SCI and T-SCI patients, those admitted to a specialist SCIRU tended to be younger (P = 0.000), have a longer length of stay in rehabilitation (P = 0.000), and lower Functional Independence Measure (FIM) motor subscale score on admission (P = 0.000) than those admitted to a NSRU. For NT-SCI patients, after adjusting for covariates, those admitted into specialist SCIRU had greater improvement in their FIM motor score during rehabilitation. This finding was not demonstrated in T-SCI patients. Conclusions: There are differences in the characteristics of SCI patients admitted to SCIRU compared with NSRU. NT-SCI patients admitted to SCIRU have greater functional gain. Sponsorship: This project was made possible by a major research grant from the Victorian Neurotrauma Initiative. A minor research grant was also provided by the Australasian Faculty of Rehabilitation Medicine 2007 Ipsen research scholarship. The authors would like to thank these organisations for their support. These organisations had no role in the design, analysis or preparation of this manuscript. Spinal Cord (2011) 49, 909-916; doi:10.1038/sc.2011.29; published online 5 April 2011