The Effect of Shorter Lengths of Stay on Functional Outcomes of Spinal Cord Injury Rehabilitation

This study explores differences in length of stay (LOS) and functional status at time of discharge (DC) from inpatient rehabilitation and at 2 months post-DC (PDC) and examines complications PDC for patients admitted to a rehabilitation center in 1991 and 1995. Data were collected from 127 patients with motor complete spinal cord injury (SCI). Nineteen functional skills, medical complications, and employment status were collected. LOS was shorter in 1995 (54.2 days) than in 1991 (95.8 days). The 1991 patients with paraplegia were functioning more independently in 5 of the 19 skills, whereas in 1995 these patients functioned more independently in one skill PDC. Individuals with tetraplegia showed no difference in functional level at DC but did show functional improvement at PDC in 1995 for three skills. Urinary tract infections and pressure ulcers were not different between the groups, but pain complaints and unemployment status were greater in 1995 for individuals with paraplegia. Results indicate that LOS may have decreased to a point that is detrimental to patient outcomes.