title: Acute rehospitalizations during inpatient rehabilitation for spinal cord injury.
abstract: OBJECTIVE
  To investigate frequency of and reasons for readmission to acute care (RTAC) during inpatient rehabilitation after traumatic spinal cord injury (SCI), and to identify factors associated with RTAC.
  
  
  METHODS
  Prospective observational cohort.
  
  
  METHODS
  Inpatient rehabilitation.
  
  
  METHODS
  Individuals with SCI (N=1376) consecutively admitted for inpatient rehabilitation; 1032 randomly selected for model development; 344 selected for model cross-validation.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  RTAC, RTAC reasons, rehabilitation length of stay (LOS), discharge location and FIM, rehospitalization between discharge and year 1, and 1-year outcomes: FIM, Craig Handicap Assessment and Reporting Technique, and Patient Health Questionnaire-9.
  
  
  RESULTS
  Participants (n=116; 11%) experienced RTAC with a total 143 episodes--96 patients experienced only 1 RTAC, while 14 had 2 RTACs, 5 had 3 RTACs, and 1 had 4 RTACs. The most common RTAC reasons were surgery (36%), infection (22%), noninfectious respiratory (14%), and gastrointestinal (8%). Mean days ± SD from rehabilitation admission to first RTAC was 27 ± 30 days. Seventy-four (7%) patients had at least 1 RTAC for medical reasons and 46 (4%) for surgical reasons. Regression analyses indicated several variables were associated with RTACs: greater admission medical severity, lower admission cognitive FIM, pressure ulcer acquired in acute care, and study site. Medical RTACs were associated with higher body mass index, lower admission cognitive and motor FIM, payer, and study site. Predictors of surgical RTAC were longer time from injury to rehabilitation admission and study site. After controlling for the other variables, the only outcome RTAC influenced was longer rehabilitation LOS.
  
  
  CONCLUSIONS
  Approximately 11% of SCI patients experience RTAC during the course of rehabilitation for a variety of medical and surgical reasons. RTACs are associated with longer rehabilitation LOS.
authors.affiliation: Carolinas Rehabilitation, Charlotte, NC, USA. flora.hammond@rhin.com
authors.forename: Flora M
authors.initials: FM
authors.lastname: Hammond
authors.forename: Susan D
authors.initials: SD
authors.lastname: Horn
authors.forename: Randall J
authors.initials: RJ
authors.lastname: Smout
authors.forename: David
authors.initials: D
authors.lastname: Chen
authors.forename: Gerben
authors.initials: G
authors.lastname: DeJong
authors.forename: William
authors.initials: W
authors.lastname: Scelza
authors.forename: Amitabh
authors.initials: A
authors.lastname: Jha
authors.forename: Pamela H
authors.initials: PH
authors.lastname: Ballard
authors.forename: Jessica
authors.initials: J
authors.lastname: Bloomgarden
mesh_terms: D000328:Adult; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010359:Patient Readmission / Q000706:statistics & numerical data*; D011446:Prospective Studies; D020127:Recovery of Function; D012043:Regression, Psychology; D012720:Severity of Illness Index; D012959:Socioeconomic Factors; D013119:Spinal Cord Injuries / Q000534:rehabilitation*; D013997:Time Factors; D014481:United States