A latent structural analysis of health outcomes among people living with spinal cord injury

Publication date: Available online 3 June 2017
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Chao Li, Jillian M.R. Clark, James S. Krause
ObjectiveTo develop a latent structural model of health outcomes among people with spinal cord injury (SCI) that accounts for measurement of underlying factors and their association with demographic and injury-related exogenous variables.DesignCross-sectional studySettingsData were collected at a large specialty hospital and analyzed at a medical university in the Southeastern United StatesParticipants1871 participants with traumatic SCI of at least 1-year durationInterventionsN/AMain Outcome MeasuresExploratory factor analysis (EFA) was used to identify latent health outcome structures. Several key exogenous variables were also linked with the latent health outcome factors.ResultsSix latent health outcome factors were identified by the EFA with excellent model fit (root mean square error of approximation = 0.040). These latent factors included: (1) global health problems, (2) chronic disease, (3) acute treatments, (4) symptoms of SCI complications, (5) pressure ulcers, and (6) subsequent injuries. Sex, race/ethnicity, age, years since injury, and injury severity were all significantly associated with at least 1 latent health outcome factor, which indicates these latent health outcomes varied as a function of the exogenous variables.ConclusionThis study improved our understanding of the structure of health outcomes, and utilization of latent health outcome factors provides more stable and comprehensive composite scores than does utilization of a single observed health outcome indicator.



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