Assessing the Ability of Comorbidity Indexes to Capture Comorbid Disease in the Inpatient Rehabilitation Spinal Cord Injury Population.

Abstract:

OBJECTIVE:To examine whether commonly used comorbidity indexes (Deyo-Charlson comorbidity index, Elixhauser comorbidity index, the Centers for Medicare and Medicaid Services [CMS] comorbidity tiers) capture comorbidities in the acute traumatic and nontraumatic SCI inpatient rehabilitation population. DESIGN:Retrospective cross-sectional study. PARTICIPANTS:Data were obtained from the Uniform Data System for Medical Rehabilitation from October 1, 2015 to December 31, 2017 for adults with spinal cord injury (SCI) (Medicare-established Impairment Group Codes 04.110-04.230, 14.1, 14.3). This study included SCI discharges (N=66,235) from 833 inpatient rehabilitation facilities. MAIN OUTCOME MEASURES:International Classification of Diseases-10th Revision-Clinical Modifications (ICD-10-CM) codes were used to assess 3 comorbidity indexes (Deyo-Charlson comorbidity index, Elixhauser comorbidity index, CMS comorbidity tiers). The comorbidity codes that occurred with >1% frequency were reported. The percentages of discharges for which no comorbidities were captured by each comorbidity index were calculated. RESULTS:Of the total study population, 39,285 (59.3%) were men and 11,476 (17.3%) were tetraplegic. The mean number of comorbidities was 14.7. There were 13,939 distinct ICD-10-CM comorbidity codes. There were 237 comorbidities that occurred with >1% frequency. The Deyo-Charlson comorbidity index, Elixhauser comorbidity index, and the CMS tiers did not capture comorbidities of 58.4% (95% confidence interval, 58.08%-58.84%), 29.4% (29.07%-29.76%), and 66.1% (65.73%-66.46%) of the discharges in our study, respectively, and 28.8% (28.42%-29.11%) of the discharges did not have any comorbidities captured by any of the comorbidity indexes. CONCLUSION:Commonly used comorbidity indexes do not reflect the extent of comorbid disease in the SCI rehabilitation population. This work suggests that alternative measures may be needed to capture the complexity of this population.

journal_name

Arch Phys Med Rehabil

authors

Huang D,Siddiqui S,Slocum CS,Goldstein R,Zafonte RD,Schneider JC

doi

10.1016/j.apmr.2020.04.025

subject

Has Abstract

pub_date

2020-10-01 00:00:00

pages

1731-1738

issue

10

eissn

0003-9993

issn

1532-821X

pii

S0003-9993(20)30307-5

journal_volume

101

pub_type

杂志文章
  • Isometric torso rotation strength: effect of training frequency on its development.

    abstract:OBJECTIVE:To examine training frequency's effect on torso rotation muscle strength. DESIGN:The study followed a pretest-posttest randomized-group design. SETTING:University laboratory. PATIENTS:Subjects, 33 men (age 30 +/- 11yr) and 25 women (age 28 +/- 10yr) with no history of low back pain, volunteered to particip...

    journal_title:Archives of physical medicine and rehabilitation

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1016/s0003-9993(97)90012-5

    authors: DeMichele PL,Pollock ML,Graves JE,Foster DN,Carpenter D,Garzarella L,Brechue W,Fulton M

    更新日期:1997-01-01 00:00:00

  • Cognitive impairment in patients with traumatic brain injury and obstructive sleep apnea.

    abstract:OBJECTIVE:To examine the impact of comorbid obstructive sleep apnea (OSA) on the cognitive functioning of traumatic brain injury (TBI) patients. DESIGN:A case-control study. Neuropsychologic test performances of TBI patients with OSA were compared with those who did not have OSA. The diagnosis of OSA was based on stan...

    journal_title:Archives of physical medicine and rehabilitation

    pub_type: 杂志文章,多中心研究

    doi:10.1016/j.apmr.2007.07.012

    authors: Wilde MC,Castriotta RJ,Lai JM,Atanasov S,Masel BE,Kuna ST

    更新日期:2007-10-01 00:00:00

  • Balance self-efficacy and its relevance to physical function and perceived health status after stroke.

    abstract:OBJECTIVES:To estimate the level of balance self-efficacy among community-dwelling subjects with stroke and to determine the relative importance of balance self-efficacy compared with functional walking capacity in predicting physical function and perceived health status. DESIGN:Secondary analysis of baseline, postint...

    journal_title:Archives of physical medicine and rehabilitation

    pub_type: 杂志文章

    doi:10.1016/j.apmr.2005.11.017

    authors: Salbach NM,Mayo NE,Robichaud-Ekstrand S,Hanley JA,Richards CL,Wood-Dauphinee S

    更新日期:2006-03-01 00:00:00

  • Fibrocartilaginous emboli to the spinal cord: a case report.

    abstract::Fibrocartilaginous emboli to spinal cord vessels are a rare and fatal cause of spinal cord injury. We reviewed the medical literature and discovered only 24 cases reported, all in the last 28 years. For all previously reported patients, onset of initial symptoms to maximal neurologic deficit was from a few minutes to ...

    journal_title:Archives of physical medicine and rehabilitation

    pub_type: 杂志文章,评审

    doi:

    authors: Bockenek WL,Bach JR,Alba AS,Cravioto HM

    更新日期:1990-09-01 00:00:00

  • Specific Brain Lesions Impair Explicit Motor Imagery Ability: A Systematic Review of the Evidence.

    abstract:OBJECTIVE:To determine which neurologic disorders/lesions impair or restrict motor imagery (MI) ability. DATA SOURCES:CINAHL, Cochrane, Embase, MEDLINE, Web of Science, PsychINFO, Physiotherapy Evidence Database, and Grey Literature were searched between May 8 and May 14, 2014. Keywords and Medical Subject Headings fr...

    journal_title:Archives of physical medicine and rehabilitation

    pub_type: 杂志文章,评审

    doi:10.1016/j.apmr.2015.07.012

    authors: McInnes K,Friesen C,Boe S

    更新日期:2016-03-01 00:00:00

  • Satisfaction and problems experienced with transfemoral suspension systems: a comparison between common suction socket and seal-in liner.

    abstract:OBJECTIVE:To compare a seal-in liner with the common suction socket with regards to patient satisfaction and problems experienced with the prosthesis. DESIGN:Retrospective survey. SETTING:A medical and engineering research center and a department of biomechanical engineering. PARTICIPANTS:Men (N=90) with traumatic t...

    journal_title:Archives of physical medicine and rehabilitation

    pub_type: 杂志文章

    doi:10.1016/j.apmr.2012.12.007

    authors: Gholizadeh H,Abu Osman NA,Eshraghi A,Ali S,Yahyavi ES

    更新日期:2013-08-01 00:00:00

  • Effect of lower limb on body propulsion.

    abstract::The purpose of this study was to analyze and compare the effects of the leg during swing and stance phases of forward propulsion of the body for both men and women. Twelve able-bodied subjects, six men and six women, were studied with a Vicon(a) gait-analysis system. A two-dimensional, sagittal-plane biomechanical ana...

    journal_title:Archives of physical medicine and rehabilitation

    pub_type: 杂志文章

    doi:

    authors: Dillingham TR,Lehmann JF,Price R

    更新日期:1992-07-01 00:00:00

  • Aspiration in patients with acute stroke.

    abstract:OBJECTIVES:To determine the frequency and clinical predictors of aspiration within 5 days of acute stroke. DESIGN:Case series. SETTING:Tertiary care center. PATIENTS:Consecutive stroke patients (n = 55) with new neurologic deficit evaluated within 5 days of acute stroke. MAIN OUTCOME MEASURES:Comparison of features...

    journal_title:Archives of physical medicine and rehabilitation

    pub_type: 杂志文章

    doi:10.1016/s0003-9993(98)90200-3

    authors: Daniels SK,Brailey K,Priestly DH,Herrington LR,Weisberg LA,Foundas AL

    更新日期:1998-01-01 00:00:00

  • Assessing pain in patients with severe cerebral palsy: development, reliability, and validity of a pain assessment instrument for cerebral palsy.

    abstract:OBJECTIVES:To develop the Pain Assessment Instrument for Cerebral Palsy (PAICP) and to study its test-retest reproducibility and construct validity. DESIGN:Cross-sectional validation study. SETTING:Homes for severely handicapped. PARTICIPANTS:A total of 164 adults with severe cerebral palsy (CP), caregivers, and phy...

    journal_title:Archives of physical medicine and rehabilitation

    pub_type: 杂志文章

    doi:10.1016/j.apmr.2003.06.029

    authors: Boldingh EJ,Jacobs-van der Bruggen MA,Lankhorst GJ,Bouter LM

    更新日期:2004-05-01 00:00:00

  • Injury and demographic factors predictive of disparities in earnings after spinal cord injury.

    abstract:OBJECTIVE:To identify differences in earnings after spinal cord injury (SCI) attributable to demographic factors, injury severity, and education using a regression model that accounts for employment status, conditional earnings (earnings of those employed only), and unconditional earnings (earnings from employment for ...

    journal_title:Archives of physical medicine and rehabilitation

    pub_type: 杂志文章

    doi:10.1016/j.apmr.2006.07.254

    authors: Krause JS,Terza JV

    更新日期:2006-10-01 00:00:00

  • Effects of Feldenkrais method on chronic neck/scapular pain in people with visual impairment: a randomized controlled trial with one-year follow-up.

    abstract:OBJECTIVE:To determine whether the Feldenkrais method is an effective intervention for chronic neck/scapular pain in patients with visual impairment. DESIGN:Randomized controlled trial with an untreated control group. SETTING:Low vision center. PARTICIPANTS:Patients (N=61) with visual impairment (mean, 53.3 y) and n...

    journal_title:Archives of physical medicine and rehabilitation

    pub_type: 杂志文章,随机对照试验

    doi:10.1016/j.apmr.2014.05.013

    authors: Lundqvist LO,Zetterlund C,Richter HO

    更新日期:2014-09-01 00:00:00

  • Benjamin Franklin: the first physiatrist?

    abstract::Benjamin Franklin would have been an excellent physiatrist. In this short address, I explore the qualities that Franklin possessed in the medical realm. Several ways in which we can emulate some of his traits to become better physiatrists are proposed. ...

    journal_title:Archives of physical medicine and rehabilitation

    pub_type: 历史文章

    doi:10.1016/j.apmr.2007.01.006

    authors: Gnatz SM

    更新日期:2007-05-01 00:00:00

  • Illness and demographic correlates of chronic pain among a community-based sample of people with multiple sclerosis.

    abstract:OBJECTIVE:To investigate the prevalence, nature, and correlates of pain among a community-based sample with multiple sclerosis (MS). DESIGN:A cross-sectional survey and structured pain interview. SETTING:Community. PARTICIPANTS:People with MS (N=219) recruited through systematic sampling from a randomly ordered MS s...

    journal_title:Archives of physical medicine and rehabilitation

    pub_type: 杂志文章

    doi:10.1016/j.apmr.2008.03.022

    authors: Douglas C,Wollin JA,Windsor C

    更新日期:2008-10-01 00:00:00

  • The longitudinal relation between physical capacity and wheelchair skill performance during inpatient rehabilitation of people with spinal cord injury.

    abstract:OBJECTIVE:To study the longitudinal relation between physical capacity and wheelchair skill performance in subjects with spinal cord injury (SCI) during rehabilitation. DESIGN:Observational prospective cohort study. Measurements were taken 3 times during subjects' rehabilitation. SETTING:Eight rehabilitation centers ...

    journal_title:Archives of physical medicine and rehabilitation

    pub_type: 杂志文章

    doi:10.1016/j.apmr.2005.03.020

    authors: Kilkens OJ,Dallmeijer AJ,Nene AV,Post MW,van der Woude LH

    更新日期:2005-08-01 00:00:00

  • Assessing Physical Activity in Inpatient Rehabilitation: validity, practicality, and sensitivity to change in the physical activity in inpatient rehabilitation assessment.

    abstract:OBJECTIVE:To validate a novel assessment of inpatient physical activity. DESIGN:Prospective cohort study for the evaluation of a novel questionnaire for physical activity in geriatric inpatients. SETTING:German geriatric inpatient rehabilitation unit. PARTICIPANTS:Patients (N=96; 67 [72%] women; median age, 81y) wit...

    journal_title:Archives of physical medicine and rehabilitation

    pub_type: 杂志文章

    doi:10.1016/j.apmr.2011.06.032

    authors: Denkinger MD,Lindemann U,Nicolai S,Igl W,Jamour M,Nikolaus T

    更新日期:2011-12-01 00:00:00

  • Effect of high- and low-frequency repetitive transcranial magnetic stimulation on visuospatial neglect in patients with acute stroke: a double-blind, sham-controlled trial.

    abstract:OBJECTIVE:To compare the therapeutic effect of low- and high-frequency repetitive transcranial magnetic stimulation (rTMS) of the posterior parietal cortex (PPC) in patients with acute stroke with visuospatial neglect. DESIGN:This study was a prospective, double-blind, sham-controlled trial. Data are presented from 27...

    journal_title:Archives of physical medicine and rehabilitation

    pub_type: 杂志文章,随机对照试验

    doi:10.1016/j.apmr.2012.12.016

    authors: Kim BR,Chun MH,Kim DY,Lee SJ

    更新日期:2013-05-01 00:00:00

  • Association of Patterns of Moderate-to-Vigorous Physical Activity Bouts With Pain, Physical Fatigue, and Disease Severity in Women With Fibromyalgia: the al-Ándalus Project.

    abstract:OBJECTIVES:To examine the associations of non-bouted moderate-to-vigorous physical activity (MVPA) and patterns of MVPA in bouts ≥10 minutes with pain, physical fatigue, and disease severity in women with fibromyalgia, and test whether these associations are independent of sedentary time (ST) and physical fitness (PF)....

    journal_title:Archives of physical medicine and rehabilitation

    pub_type: 杂志文章

    doi:10.1016/j.apmr.2018.12.019

    authors: Segura-Jiménez V,Estévez-López F,Castro-Piñero J,Álvarez-Gallardo IC,Soriano-Maldonado A,Borges-Cosic M,Delgado-Fernández M

    更新日期:2019-07-01 00:00:00

  • Recovery of strength at the zone of injury in motor complete and motor incomplete cervical spinal cord injured patients.

    abstract::This study compared the time of recovery at the zone of injury between motor complete (Frankel A and B) and motor incomplete (Frankel C and D) cervical spinal cord injured patients for the biceps (C5), extensor carpi radialis (C6), and triceps (C7) muscles. Manual muscle testing was performed initially three to seven ...

    journal_title:Archives of physical medicine and rehabilitation

    pub_type: 杂志文章

    doi:

    authors: Mange KC,Ditunno JF Jr,Herbison GJ,Jaweed MM

    更新日期:1990-07-01 00:00:00

  • Benefits of home health care after inpatient rehabilitation for hip fracture: health service use by Medicare beneficiaries, 1987-1992.

    abstract:OBJECTIVE:To examine the added benefit of home health services for elderly patients with hip fracture discharged home after inpatient rehabilitation. DATA:Medicare claims from 1% of 1986 beneficiaries followed until 1992. STUDY POPULATION:Persons hospitalized with hip fracture at 70 years or older who had no major Me...

    journal_title:Archives of physical medicine and rehabilitation

    pub_type: 杂志文章

    doi:10.1016/s0003-9993(98)90261-1

    authors: Intrator O,Berg K

    更新日期:1998-10-01 00:00:00

  • Needling therapies in the management of myofascial trigger point pain: a systematic review.

    abstract:OBJECTIVE:To establish whether there is evidence for or against the efficacy of needling as a treatment approach for myofascial trigger point pain. DATA SOURCES:PubMed, Ovid MEDLINE, Ovid EMBASE, the Cochrane Library, AMED, and CISCOM databases, searched from inception to July 999. STUDY SELECTION:Randomized, control...

    journal_title:Archives of physical medicine and rehabilitation

    pub_type: 杂志文章,评审

    doi:10.1053/apmr.2001.24023

    authors: Cummings TM,White AR

    更新日期:2001-07-01 00:00:00

  • Radiation exposure of the spinal interventionalist performing fluoroscopically guided lumbar transforaminal epidural steroid injections.

    abstract:OBJECTIVE:To evaluate radiation exposure to spinal interventionalists while performing transforaminal epidural steroid injections (TFESIs). DESIGN:Prospective study. SETTING:Multidisciplinary spine center. PARTICIPANTS:One hundred consecutive patients with either herniated nucleus pulposus (HNP) or lumbar spinal ste...

    journal_title:Archives of physical medicine and rehabilitation

    pub_type: 杂志文章

    doi:10.1053/apmr.2002.32439

    authors: Botwin KP,Thomas S,Gruber RD,Torres FM,Bouchlas CC,Rittenberg JJ,Rao S

    更新日期:2002-05-01 00:00:00

  • Isotopic Scintigraphy Coupled With Computed Tomography for the Investigation of Intrathecal Baclofen Device Malfunction.

    abstract:OBJECTIVE:To assess the potential use of indium-111 diethylenetriamine pentaacetic acid ((111)In-DTPA) scintigraphy coupled with computed tomography (CT) for the investigation of intrathecal baclofen (ITB) device malfunction. DESIGN:Retrospective study of a case series of patients. SETTING:Neurosurgical and physical ...

    journal_title:Archives of physical medicine and rehabilitation

    pub_type: 杂志文章

    doi:10.1016/j.apmr.2015.10.101

    authors: Frémondière F,Lacoeuille F,Sher A,Couturier O,Menei P,Richard I,Dinomais M

    更新日期:2016-04-01 00:00:00

  • Prescribed versus actual length of stay and inpatient neurorehabilitation outcome for brain dysfunctional patients.

    abstract:OBJECTIVE:To determine (1) whether brain dysfunctional patients have better rehabilitation outcomes if they receive prescribed length of stay (LOS) versus less than prescribed and (2) if LOS and cognitive status relate to goal attainment. DESIGN:Prospective inception cohort study. STUDY SETTING:Medical center and a n...

    journal_title:Archives of physical medicine and rehabilitation

    pub_type: 杂志文章

    doi:10.1016/s0003-9993(97)90428-7

    authors: Prigatano GP,Wong JL,Williams C,Plenge KL

    更新日期:1997-06-01 00:00:00

  • Reliability and validity of clinical tests for measuring strength or endurance of cervical muscles: A systematic review and meta-analysis.

    abstract:OBJECTIVE:To evaluate the reliability and validity of clinical tests for measuring cervical muscle strength or endurance in participants with and without neck pain. DATA SOURCE:Systematic review and meta-analysis on reliability and validity. Literature search was conducted on January 28, 2020, using 5 databases: MEDLI...

    journal_title:Archives of physical medicine and rehabilitation

    pub_type: 杂志文章,评审

    doi:10.1016/j.apmr.2020.11.018

    authors: Approbato Selistre LF,de Sousa Melo C,Amaral de Noronha M

    更新日期:2020-12-28 00:00:00

  • Factors influencing the return to work of patients after hip replacement and rehabilitation.

    abstract:OBJECTIVE:To determine the incidence of medical and sociocultural factors on the return to work of patients after hip replacement and rehabilitation treatment. DESIGN:Case review. Frequency and association of variables' analysis. SETTING:The rehabilitation unit of a general hospital in Oviedo (Spain). This setting is...

    journal_title:Archives of physical medicine and rehabilitation

    pub_type: 杂志文章

    doi:10.1016/s0003-9993(96)90110-0

    authors: Suarez J,Arguelles J,Costales M,Arechaga C,Cabeza F,Vijande M

    更新日期:1996-03-01 00:00:00

  • A 2-item screen for depression in rehabilitation inpatients.

    abstract:OBJECTIVE:To generate a brief screening measure to assist frontline rehabilitation health care workers to rapidly and validly screen patients for depressive symptoms. DESIGN:Case series. SETTING:Inpatient rehabilitation unit. PARTICIPANTS:Five hundred patients (age, >/=60y) cognitively able to complete the outcome m...

    journal_title:Archives of physical medicine and rehabilitation

    pub_type: 杂志文章

    doi:10.1016/j.apmr.2004.04.042

    authors: Cully JA,Graham DP,Kramer JR

    更新日期:2005-03-01 00:00:00

  • The effect of a high resistance exercise program in slowly progressive neuromuscular disease.

    abstract::A 12-week high resistance home exercise program was completed by 10 subjects with slowly progressive neuromuscular diseases (NMD) and 6 normal control subjects (CTL). After evaluating baseline maximal isometric and isokinetic strength of the elbow flexors and knee extensors, subjects completed the home program using a...

    journal_title:Archives of physical medicine and rehabilitation

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:

    authors: Kilmer DD,McCrory MA,Wright NC,Aitkens SG,Bernauer EM

    更新日期:1994-05-01 00:00:00

  • Botulinum toxin for spasticity and athetosis in children with cerebral palsy.

    abstract::Botulinum toxin A has been used therapeutically in humans for a variety of conditions since 1980. Over the past few years, it has been used more frequently for spasticity management. We describe the use of botulinum toxin for spasticity or athetosis management in three children with cerebral palsy. Two of these childr...

    journal_title:Archives of physical medicine and rehabilitation

    pub_type: 杂志文章

    doi:10.1016/s0003-9993(96)90042-8

    authors: Gooch JL,Sandell TV

    更新日期:1996-05-01 00:00:00

  • Rehabilitation treatment taxonomy: establishing common ground.

    abstract::This article introduces the Archives supplement presenting a conceptual framework for the creation of a rehabilitation treatment taxonomy (RTT). It describes the key theoretical and empirical articles and their role, and the commentaries that were solicited. More importantly, based on feedback received to date, it ske...

    journal_title:Archives of physical medicine and rehabilitation

    pub_type:

    doi:10.1016/j.apmr.2013.09.023

    authors: Dijkers MP

    更新日期:2014-01-01 00:00:00

  • Isometric torque of the quadriceps femoris after concentric, eccentric and isometric training.

    abstract::Twenty-seven normal, healthy women participated in this study, which investigated three methods of increasing the isometric strength of the quadriceps femoris through a six-week training program. Three experimental exercise groups were formed: A, eccentric, B, concentric, and C, isometric. The peak isometric torque of...

    journal_title:Archives of physical medicine and rehabilitation

    pub_type: 杂志文章

    doi:

    authors: Pavone E,Moffat M

    更新日期:1985-03-01 00:00:00