BACKGROUND: People with spinal cord injury (PWSCI) face various challenges after being discharged from rehabilitation that can result in
readmission to hospital. Little is known about readmission of PWSCI in South Africa (SA). Readmission is costly, interrupts community
involvement and negatively affects quality of life.
Objectives. To investigate readmission rates within 5 years of rehabilitation, causes of readmission and factors related to readmission in
PWSCI in Pretoria, SA.
METHODS: We quantitatively analysed retrospective data gathered from files of patients admitted to a private rehabilitation facility in
Pretoria between January 2008 and December 2012. Data were analysed using Stata 13 statistical software. Descriptive statistics were
initially presented. Univariate logistic regression was used to identify individual factors that had significant association with the outcome
measure (readmission). Thereafter, multivariate logistic regression was used to identify risk factors for readmission. The level of statistical
significance was set at p<0.5.
RESULTS: Data from 543 patient files were analysed. In total, 100 patients (18%) were readmitted between January 2008 and December 2012.
Twenty-eight of the 100 readmitted patients had a subsequent second readmission, 10 patients had a third readmission, and 2 patients were
readmitted for a fourth time. The most common reason for readmission was secondary health conditions (SHCs) (80%), followed by further
rehabilitation, including gait rehabilitation (12%). Eight patients (8%) had undocumented reasons for readmission. The common SHCs in
the first readmission were pressure ulcers (39%), followed by urinary tract infections (12%), deteriorating neurological status (6%) and
constipation (3%). Patients with paraplegia had 2.3 times greater odds of readmission compared with tetraplegics (p=0.000, 95% CI 1.47 -
3.55). Those in the category T1 - T6 level of injury had 2.6 times greater odds of readmission (p=0.04, 95% CI 1.04 - 6.71, while those with
incomplete spinal cord injury had 2.5 times greater odds (p=0.001, 95% CI 1.44 - 4.46).
CONCLUSIONS: Factors related to patient injury profile such as type, completeness and level of injury were associated with a significant risk of
readmission. SHCs were the main cause of readmission, and there is a need for effective programmes for their prevention.