title: Clinical features and inpatient rehabilitation outcomes of infection-related myelopathy.
abstract: METHODS
  This was a retrospective cohort study.
  
  
  OBJECTIVE
  The objectives of this study were to determine clinical features of infection-related myelopathy (IRM) and functional outcomes compared with other nontraumatic and traumatic myelopathies.
  
  
  METHODS
  US academic inpatient rehabilitation unit.
  
  
  METHODS
  This was a 16-year retrospective review of patients with myelopathy discharged from inpatient rehabilitation between 1 January 1995 and 31 December 2010. Patients comprised three injury groups: IRM, nontraumatic myelopathy (NTM) and traumatic spinal cord injury (TSCI). Information collected includes demographic characteristics, functional data, length of stay, injury completeness and discharge destination. Primary outcome measures were change in Functional Independence Measure (FIM) and daily FIM change. For IRM, data were collected regarding injury characteristics, risk factors, presenting symptoms, neurologic impairment level and treatment.
  
  
  RESULTS
  Of the 1601 patients, 40 (2.5%) had IRM, 1105 (69.0%) had NTM and 456 (28.5%) had TSCI. IRM mean (s.d.) age was 58.6 (15.7) years (male gender, 72.5%). The majority in each group had incomplete injuries. IRM had longer lengths of stay (P<0.001), lower admission (P=0.001) and discharge (P=0.005) FIM scores and lower FIM daily change (P=0.002) than NTM. Degree of functional improvement was similar in all groups, and most patients in each group were discharged home. Infectious pathogens were bacterial (80.0%, n=32), viral (7.5%, n=3), tuberculous (7.5%, n=3), parasitic (2.5%, n=1) and multiple types (2.5%, n=1). The most common bacterial cause (65.6%) was Staphylococcus aureus.
  
  
  CONCLUSIONS
  Infectious etiologies comprise a small proportion of NTM but represent a unique entity with distinct recovery patterns and outcomes. These patients can achieve similar functional improvements as other NTM patients during inpatient rehabilitation, although over a longer period of time.
authors.affiliation: Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN, USA.
authors.forename: M L
authors.initials: ML
authors.lastname: Brubaker
authors.affiliation: Mayo Medical School, Mayo Clinic College of Medicine, Rochester, MN, USA.
authors.forename: M T
authors.initials: MT
authors.lastname: Luetmer
authors.affiliation: Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN, USA.
authors.forename: R K
authors.initials: RK
authors.lastname: Reeves
mesh_terms: D000368:Aged; D002494:Central Nervous System Infections / Q000150:complications* / Q000453:epidemiology / Q000503:physiopathology / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D007297:Inpatients; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D013118:Spinal Cord Diseases / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology / Q000534:rehabilitation*; D013211:Staphylococcus aureus; D016896:Treatment Outcome