Length of stay in hospital following spinal cord lesions in Israel

Abstract

Study Design: Retrospective cohort study. Objective: To monitor length of stay (LOS) in a specialist spinal cord lesion (SCL) department in Israel, evaluate factors that affect it, and assess its association with other outcome measures. Setting: Loewenstein Rehabilitation Hospital, Raanana, Israel. Methods: In all, 1367 SCL patients treated between 1962 and 2000, and a group of 44 patients admitted between 1996 and 2002 were recruited. LOS, factors that affect it, and Spinal Cord Independence Measure second version (SCIM-II) gain and efficiency were measured. Data were collected from hospital charts and from the Population Registry of the Israel Ministry of Internal Affairs. LOS associations were analyzed with ANOVA, ANCOVA, Pearson's χ2 test, Pearson's correlation, and Cox proportional hazard model. Results: The mean LOS was 239 days for traumatic SCL (SD = 168) and 106 days for nontraumatic SCL (SD = 137). SCL etiology, SCL severity, and decade of admission to rehabilitation, were associated with the LOS (P < 0.001). SCIM II gain correlated with LOS in the first 70 days after admission (r = 0.81-0.82; P < 0.001). In some patients, longer LOS was associated with a considerable increase in ability, through 5-8 months from admission. Conclusions: LOS of patients with SCL in Israel is within the customary LOS range in Europe. Longer LOS in a specialist SCL department may be positively associated with improved rehabilitation outcome. Further study is required to determine the LOS that allows optimal achievements.