Association Between Time to Rehabilitation and Outcomes After Traumatic Spinal Cord Injury.
To examine the relations between time to rehabilitation after spinal cord injury (SCI) and rehabilitation outcomes at discharge and 1-year postinjury.



Retrospective cohort study.



Facilities designated as Spinal Cord Injury Model Systems.



Patients (N=3937) experiencing traumatic SCI between 2000 and 2014, who were 18 years or older, and who were admitted to a model system within 24 hours of injury.



Not applicable.



Rasch-transformed FIM motor score at discharge and 1-year postinjury, discharge to a private residence, and the Craig Handicap Assessment and Reporting Technique (CHART) Physical Independence and Mobility scores at 1-year postinjury.



After accounting for health status, a 10% increase in time to rehabilitation was associated with a 1.50 lower FIM motor score at discharge (95% confidence interval [CI], -2.43 to -0.58; P=.001) and a 3.92 lower CHART Physical Independence score at 1-year postinjury (95% CI, -7.66 to -0.19; P=.04). Compared to the mean FIM motor score (37.5) and mean CHART Physical Independence score (74.7), the above-mentioned values represent relative declines of 4.0% and 5.3%, respectively. There was no association between time to rehabilitation and discharge to a private residence, 1-year FIM motor score, or the CHART mobility score.



Earlier rehabilitation after traumatic SCI may improve patients' functional status at discharge.
Medical Scientist Training Program, Johns Hopkins School of Medicine, Baltimore, MD. Electronic address: kherzer@jhmi.edu.
Kurt R
KR
Herzer
Department of Physical Medicine and Rehabilitation, University of Alabama at Birmingham, Birmingham, AL.
Yuying
Y
Chen
Center for Rehabilitation Outcomes Research, Rehabilitation Institute of Chicago, Chicago, IL; Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, IL.
Allen W
AW
Heinemann
Department of Physical Medicine and Rehabilitation, Johns Hopkins School of Medicine, Baltimore, MD.
Marlis
M
González-Fernández
D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D026741:Physical Therapy Modalities / Q000706:statistics & numerical data*; D020127:Recovery of Function; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D013119:Spinal Cord Injuries / Q000534:rehabilitation*; D061665:Time-to-Treatment / Q000706:statistics & numerical data*; D015599:Trauma Severity Indices; D016896:Treatment Outcome; D055815:Young Adult
Models, econometric; Outcome assessment (health care); Rehabilitation; Spinal cord injuries