Do preinjury alcohol problems predict poorer rehabilitation progress in persons with spinal cord injury?
OBJECTIVE
To determine whether a history of alcohol-related problems is associated with inpatient rehabilitation progress.


METHODS
Cross-sectional cohort survey.


METHODS
Acute inpatient rehabilitation program in a level I trauma center.


METHODS
Seventy-six of 104 consecutive patients with spinal cord injury (SCI) who met inclusion criteria and had completed interviews and functional outcome data. Participants were on average 38 years old; 84% were white, and 86% were men. Forty-two percent had tetraplegia and 39% had a history of problem drinking.


METHODS
Not applicable.


METHODS
FIM instrument admission, discharge, and efficiency scores as well as rehabilitation length of stay (LOS).


RESULTS
The group with a history of problem drinking had significantly lower FIM admission, discharge, and efficiency scores and longer rehabilitation LOS. After controlling for potential confounding factors, a history of problem drinking accounted for a significant proportion of the variance in FIM efficiency scores.


CONCLUSIONS
A history of problem drinking may be a risk factor for poorer rehabilitation progress among patients with SCI. They may be more costly to rehabilitate and may be discharged before attaining an adequate level of independence. Despite this, the current rehabilitation prospective payment system does not recognize this common comorbid condition.
Bombardier
Charles H
CH
Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, WA 98104, USA. chb@u.washington.edu
Stroud
Michael W
MW
Esselman
Peter C
PC
Rimmele
Carl T
CT
D000203:Activities of Daily Living; D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000437:Alcoholism / Q000150:complications* / Q000453:epidemiology; D000704:Analysis of Variance; D015331:Cohort Studies; D015897:Comorbidity; D015986:Confounding Factors, Epidemiologic; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D020127:Recovery of Function; D012307:Risk Factors; D013119:Spinal Cord Injuries / Q000150:complications / Q000453:epidemiology / Q000534:rehabilitation*; D014193:Trauma Centers; D016896:Treatment Outcome; D014861:Washington / Q000453:epidemiology