title: Inpatient rehabilitation outcomes in patients with malignant spinal cord compression compared to other non-traumatic spinal cord injury: A population based study.
abstract: OBJECTIVE
  To compare and describe demographic characteristics, clinical, and survival outcomes in patients admitted for inpatient rehabilitation following malignant spinal cord compression (MSCC) or other causes of non-traumatic spinal cord injury (NT-SCI).
  
  
  METHODS
  A retrospective cohort design was employed, using data retrieved from administrative databases.
  
  
  METHODS
  Rehabilitation facilities or designated rehabilitation beds in Ontario, Canada, from April 2007 to March 2011.
  
  
  METHODS
  Patients with incident diagnoses of MSCC (N = 143) or NT-SCI (N = 1,274) admitted for inpatient rehabilitation.
  
  
  METHODS
  Demographic, impairment, functional outcome (as defined by the Functional Independence Measure (FIM)), discharge, healthcare utilization, survival, and tumor characteristics.
  
  
  RESULTS
  There was a significant improvement in the FIM from admission to discharge (mean change 20.1 ± 14.3, <0.001) in the MSCC cohort. NT-SCI patients demonstrated a higher FIM efficiency (1.2 ± 1.7 vs. 0.8 ± 0.8, <0.001) and higher total (24.0 ± 14.4 vs. 20.1 ± 14.3, <0.001) FIM gains relative to MSCC cases. However, there were no differences between the MSCC and NT-SCI cohorts in length of stay (34.6 ± 30.3 vs. 37.5 ± 35.2, P = 0.8) or discharge FIM (100.7 ± 19.6 vs. 103.3 ± 18.1, P = 0.1). Three-month, 1-year, and 3-year survival rates in the MSCC and NT-SCI cohorts were 76.2% vs. 97.6%, 46.2% vs. 93.7%, and 27.3% vs. 86.7%, respectively. The majority (65.0%) of patients with MSCC was discharged home and met their rehabilitation goals (75.5%) at comparable rates to patients with NT-SCI (69.7 and 81.3%).
  
  
  CONCLUSIONS
  Despite compromised survival, patients with MSCC make clinically significant functional gains and exhibit favorable discharge outcomes following inpatient rehabilitation. Current administrative data suggests the design and scope of inpatient rehabilitation services should reflect the unique survival-related prognostic factors in patients with MSCC.
authors.forename: Christian D
authors.initials: CD
authors.lastname: Fortin
authors.forename: Jennifer
authors.initials: J
authors.lastname: Voth
authors.forename: Susan B
authors.initials: SB
authors.lastname: Jaglal
authors.forename: B Catharine
authors.initials: BC
authors.lastname: Craven
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D000066530:Neurological Rehabilitation / Q000706:statistics & numerical data*; D009864:Ontario; D010351:Patient Discharge / Q000706:statistics & numerical data; D013117:Spinal Cord Compression / Q000453:epidemiology / Q000209:etiology / Q000534:rehabilitation*; D013120:Spinal Cord Neoplasms / Q000150:complications / Q000453:epidemiology / Q000534:rehabilitation*
keywords: Population; Rehabilitation; Spinal cord compression; Spinal cord diseases; Spinal cord neoplasms