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Gunshot Versus Nongunshot Spinal Cord Injury

Acute Care and Rehabilitation Outcomes

Putzke, John D., PhD; Richards, J. Scott, PhD; Devivo, Michael J., DrPH

American Journal of Physical Medicine & Rehabilitation: May 2001 - Volume 80 - Issue 5 - p 366-370
CME Article: Spinal Cord Injury

Putzke JD, Richards JS, Devivo MJ: Gunshot versus nongunshot spinal cord injury: acute care and rehabilitation outcomes. Am J Phys Med Rehabil 2001; 80:366–370.

Objective To examine the impact of gunshot-caused spinal cord injury on acute and rehabilitative care outcome using a case control design.

Design Two groups (i.e., gunshot-vs. nongunshot-caused spinal cord injury) of 212 individuals were matched case-for-case on age (i.e., within 10 yr), education, gender, race, marital status, primary occupation, impairment level, and Model System region. Outcome measures included length of hospital stay, functional status (FIM™), treatment charges, and home discharge rates.

Results The two groups did not differ in the length of stay during acute and rehabilitative care, charges during rehabilitative care, or postrehabilitation discharge placement. Several significant between-group differences in treatment procedures were noted (e.g., prevalence of spinal surgery), which may, in part, account for the higher acute-care charges among those persons with nongunshot-caused spinal cord injury.

Conclusion Once an individual is stabilized and admitted for rehabilitative care, gunshot etiology of spinal cord injury seems largely unrelated to the initial rehabilitation outcome.

From the Department of Physical Medicine and Rehabilitation, University of Alabama at Birmingham, Birmingham, Alabama.

Supported, in part, by the University of Alabama at Birmingham Model Spinal Cord Injury System of Care grant H133N50009 from the National Institute on Disability and Rehabilitation Research, Office of Special Education and Rehabilitation Services, Department of Education, Washington, DC.

Data used in this study were derived from the National Spinal Cord Injury Statistical Center and were contributed by the 18 currently Funded Model Spinal Cord Injury Systems of Care.

FIM™ is a trademark of the Uniform Data System for Medical Rehabilitation, a division of UB Foundation Activities, Inc.

All correspondence and requests for reprints should be addressed to J. Scott Richards, PhD, Spain Rehabilitation Center, 1717 6th Avenue South, Room 529, Birmingham, AL 35233-7330.

Objectives: Upon completion of this article, the reader should be able to (1) identify risk factors associated with spinal cord injury caused by gunshot; (2) distinguish between various types of outcome measures after spinal cord injury; and (3) demonstrate the strengths and weaknesses of case-control designs.

Level: Update.

Accreditation: The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to sponsor continuing medical education for physicians.

The Association of Academic Physiatrists designates this continuing medical education activity for a maximum of 1.5 credit hours in Category 1 of Physician’s Recognition Award of the American Medical Association. Each physician should claim only those hours of credit that he/she actually spent in the education activity.

Disclosure: disclosure statements have been obtained regarding the authors’ relationships with financial supporters of this activity. There is no apparent conflict of interest related to the context of participation of the authors of this article.

How to Obtain CME Category 1 Credits

To obtain CME Category 1 credit, this educational activity must be completed and postmarked by December 31, 2002. Participants may read the articles and take the exams issue by issue or wait to study several issues together. After reading the three CME Articles in this issue, participants may complete the Self-Assessment Exam by answering the questions on the CME Answering Sheet and the Evaluation pages, which appear later in this section. Send the completed forms to: CME Department, Association of Academics Physiatrists, 5987 E. 71st Street, Suite 112, Indianapolis, In 46220. Documentation can be received at the AAP National Office at any time throughout the year, and accurate records will be maintained for each participant. CME certificates are issued only once a year in January for the total number of credits earned during the prior year.

© 2001 Lippincott Williams & Wilkins, Inc.