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Predictive factors of hospitalization in adults with pediatric-onset SCI: a longitudinal analysis
A M January1, K Zebracki2, A Czworniak3
11] Department of Psychology, Shriners Hospitals for Children, Chicago, IL, USA [2] Orthopaedic Research & Rehabilitation Engineering Center, Marquette University, Milwaukee, WI, USA.
Insights
Adults with pediatric-onset spinal cord injury (SCI) face high hospitalization rates. Medical issues like infections and lifestyle factors such as smoking increase risk, while exercise and community activity offer protection.
Area of Science:
- Rehabilitation Medicine
- Public Health
- Epidemiology
Background:
- Pediatric-onset spinal cord injury (SCI) impacts adults long-term.
- Hospitalization is a significant concern for this population, necessitating investigation into contributing factors.
Purpose of the Study:
- To determine the prevalence and rate of hospitalizations in adults with pediatric-onset SCI.
- To identify medical and behavioral factors associated with hospitalization in this cohort.
Main Methods:
- A longitudinal survey design was employed.
- 368 adults with SCI (onset before age 19) were interviewed annually.
- Standardized measures assessed life satisfaction, health, substance use, depression, and handicap.
Main Results:
- 61% of participants reported at least one hospitalization; average stay was 14.8 days.
- Minority status, high cervical SCI, unemployment, and health insurance were linked to higher hospitalization rates.
- Pressure ulcers, UTIs, pneumonia, pain, chronic conditions, and smoking increased risk; exercise and community activity decreased risk.
Conclusions:
- Both medical conditions and lifestyle choices significantly predict hospitalization in adults with pediatric-onset SCI.
- Understanding these risk and protective factors can inform clinical strategies for prevention and management of secondary health complications.
Study Design:
Longitudinal survey.
Objectives:
To investigate the prevalence and rate of hospitalization among adults with pediatric-onset spinal cord injury (SCI) and explore medical and behavioral factors associated with hospitalization.
Methods:
This study included 368 adults who sustained a SCI prior to age 19 and were enrolled in an ongoing longitudinal study investigating the outcomes of pediatric-onset SCI. Participants were interviewed on an approximately annual basis using a study-specific questionnaire and standardized outcome measures: Satisfaction with Life Scale; Short-Form 12 Health Survey; Alcohol Use Disorders Identification Test; Patient Health Questionnaire-9 Depression Scale; and Craig Handicap Assessment and Recording Technique.
Results:
Overall, 61% of participants self-reported at least one hospitalization across all time points; average length of hospitalization was 14.8 days (±23.3). Individuals who were ethnic minorities as well as those with high cervical-level SCI were more likely to be hospitalized. Those who were unemployed and those with health-care coverage were more likely to be hospitalized and have longer hospitalization stays. The risk of hospitalization was higher with occurrence of pressure ulcers, urinary tract infections, pneumonia, pain and a chronic medical condition. Smoking cigarettes increased the risk of hospitalization, whereas those who engaged in exercise and were active in the community had lower odds of hospitalization.
Conclusion:
Both medical and lifestyle factors have an important role in predicting hospitalization. An increased understanding of the risk and protective factors associated with hospitalization should assist clinicians in developing strategies and prevention efforts to minimize secondary health complications and foster healthy lifestyle behaviors.
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