Factors Associated with Multiple Hospital Readmissions for Individuals with Spinal Cord Injury

Abstract

Objective: To identify patient-level and clinical factors associated with multiple hospital readmissions in individuals with spinal cord injury (SCI).

Design: Retrospective cohort analysis of the publicly available dataset from the SCI Rehabilitation (SCIRehab) study.

Setting: Six rehabilitation centers in the U.S. that participated in the SCIRehab study.

Participants: Individuals with traumatic SCI (N=1371) who were consecutively enrolled in the SCIRehab study.

Outcome measures: The primary outcome was all-cause hospital readmission within 1 year of discharge from a rehabilitation center. The patient-level and clinical factors include employment status, depression, caregiver support, state-funded insurance, functional status, and rehabilitation services.

Results: Of the 1170 participants included in the study, 228 were readmitted once and 120 were readmitted multiple times. In our study, 34.2% and 10.8% were readmitted more than once due to genitourinary and respiratory conditions, respectively. Lower utilization of rehabilitation services, lower functional status, unemployment, and depression were associated with higher odds of being readmitted multiple times within one year of discharge from inpatient rehabilitation facility.

Conclusion: Psychosocial and clinical factors were associated with increased risk for multiple readmissions in individuals with SCI. In order to reduce recurrent readmissions in individuals with SCI, further research is necessary to maximize efficacy of risk factor modification and prevention strategies.