TY - JOUR
T1 - Evaluating associations between trauma-related characteristics and functional recovery in individuals with spinal cord injury
AU - Hiremath, Shivayogi V.
AU - Marino, Ralph J.
AU - Coffman, Donna L.
AU - Karmarkar, Amol
AU - Tucker, Carole A.
N1 - Funding Information:
Research reported in this publication was supported by the National Center for Medical Rehabilitation Research (NCMRR), Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) of the National Institutes of Health under award number 1R03HD101064. The authors would like to thank the Pennsylvania Trauma Systems Foundation and the Trauma and Surgical Critical Care at Temple University Hospital for their support in obtaining data from the PTOS database. The authors would also like to thank the Regional Spinal Cord Injury Center of Delaware Valley, the University of Pittsburgh Model Center on Spinal Cord Injury, and the National Spinal Cord Injury Statistical Center for their support in obtaining data from the SCIMS database.
Funding Information:
This study was a retrospective cohort analysis of the deidentified data from PTOS and SCIMS databases. The PTOS and SCIMS databases were obtained from the Pennsylvania Trauma Systems Foundation and the National SCI Statistical Center, respectively. The subset of SCIMS data used for this study comes from two SCI Model Centers in the state of Pennsylvania. The PTOS database includes hospital-level data from all 42 accredited trauma centers in Pennsylvania. The SCIMS database includes information from 14 SCI Model System Centers in the United States (U.S.) funded by the National Institute on Disability, Independent Living, and Rehabilitation Research, Administration on Community Living, U.S. Department of Health and Human Services. Furthermore, PTOS has trauma data for the individuals who went on to receive inpatient rehabilitation SCI care from two Model SCI Centers in Pennsylvania, the Regional Spinal Cord Injury Center of the Delaware Valley and the University of Pittsburgh Model Center on Spinal Cord Injury. Our University’s Institutional Review Board (IRB) reviewed the study and determined that it met the criteria for IRB exempt status. We also obtained approval from the Pennsylvania Trauma Systems Foundation and the National SCI Statistical Center through data use agreements, prior to conducting this study. ,
Publisher Copyright:
© The Academy of Spinal Cord Injury Professionals, Inc. 2022.
PY - 2022
Y1 - 2022
N2 - Objective: To determine the associations between trauma variables, acute phase-related variables, and patient-level characteristics with functional recovery during inpatient rehabilitation for individuals with spinal cord injury (SCI). The associations were evaluated by linking individuals’ records between the Pennsylvania Trauma Systems Outcomes Study and the National SCI Model Systems databases. Design: Retrospective cohort analysis. Setting: Two SCI Model Centers in Pennsylvania, United States. Methods: We used a record linkage toolkit in Python to link 735 individuals with traumatic SCI between the databases. The percentage for true-match and error were 92.0% and 0.1%, respectively. The functional recovery during inpatient rehabilitation was determined in 604 individuals with SCI by ordinary least squares regression (OLS) and gradient boosting regression (GBR) analyses. Results: The OLS and GBR analyses indicated older age, greater impairment (SCI level combined with American Spinal Injury Association impairment scale), presence of diabetes mellitus, pulmonary complications during acute care, and longer length of stay at an inpatient rehabilitation facility were associated with lower functional recovery (OLS R 2= 0.56 and GBR R 2= 0.58). Conclusions: Trauma and acute care variables in addition to patient characteristics were associated with functional recovery during inpatient rehabilitation in individuals with SCI. Further investigation is needed to understand the role of diabetes mellitus and pulmonary complications, which have not been previously associated with functional recovery in individuals with SCI.
AB - Objective: To determine the associations between trauma variables, acute phase-related variables, and patient-level characteristics with functional recovery during inpatient rehabilitation for individuals with spinal cord injury (SCI). The associations were evaluated by linking individuals’ records between the Pennsylvania Trauma Systems Outcomes Study and the National SCI Model Systems databases. Design: Retrospective cohort analysis. Setting: Two SCI Model Centers in Pennsylvania, United States. Methods: We used a record linkage toolkit in Python to link 735 individuals with traumatic SCI between the databases. The percentage for true-match and error were 92.0% and 0.1%, respectively. The functional recovery during inpatient rehabilitation was determined in 604 individuals with SCI by ordinary least squares regression (OLS) and gradient boosting regression (GBR) analyses. Results: The OLS and GBR analyses indicated older age, greater impairment (SCI level combined with American Spinal Injury Association impairment scale), presence of diabetes mellitus, pulmonary complications during acute care, and longer length of stay at an inpatient rehabilitation facility were associated with lower functional recovery (OLS R 2= 0.56 and GBR R 2= 0.58). Conclusions: Trauma and acute care variables in addition to patient characteristics were associated with functional recovery during inpatient rehabilitation in individuals with SCI. Further investigation is needed to understand the role of diabetes mellitus and pulmonary complications, which have not been previously associated with functional recovery in individuals with SCI.
KW - Acute care
KW - Functional status
KW - Inpatient rehabilitation
KW - Linking
KW - Traumatic spinal cord injury
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U2 - 10.1080/10790268.2022.2112849
DO - 10.1080/10790268.2022.2112849
M3 - Article
C2 - 35993800
AN - SCOPUS:85136897420
SN - 1079-0268
JO - Journal of Spinal Cord Medicine
JF - Journal of Spinal Cord Medicine
ER -