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Title: International Retrospective Comparison of Inpatient Rehabilitation for Patients With Spinal Cord Dysfunction Epidemiology and Clinical Outcomes
Epworth Authors: New, Peter
Other Authors: Reeves, Ronald K.
Smith, Eimear
Townson, Andrea
Eriks-Hoogland, Inge
Gupta, Anupam
Maurizio, Belci
Scivoletto, Giorgo
Post, Marcel
Keywords: Delivery of Health Care
Outcome and Process Assessment (Health Care)
Spinal Cord Diseases
Spinal Rehabilitation Units
American Spinal Injury Association Impairment Scale
Epworth-Monash Rehabilitation Medicine Unit, Monash University, Melbourne, Victoria, Australia.
Issue Date: Jun-2015
Publisher: Elsevier
Citation: Arch Phys Med Rehabil. 2015 Jun;96(6):1080-7.
Abstract: OBJECTIVE: To describe and compare epidemiologic characteristics of patients with spinal cord dysfunction admitted to spinal rehabilitation units (SRUs) in 9 countries (Australia, Canada, Italy, India, Ireland, The Netherlands, Switzerland, United Kingdom, and United States). DESIGN: Retrospective multicenter open-cohort case series. SETTING: SRUs. PARTICIPANTS: Patients (N=956) with initial onset of spinal cord dysfunction consecutively admitted between January 1, 2008, and December 31, 2010. Median age on admission was 59 years (interquartile range [IQR], 46-70), and 60.8% of patients were men. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Demographic characteristics (eg, age, sex), time frame over which clinical symptoms of spinal cord dysfunction developed, etiology, length of stay in hospital, level of lesion and American Spinal Injury Association Impairment Scale (AIS) grade, discharge destination, and inpatient mortality. RESULTS: The time frame of onset of spinal cord dysfunction symptoms was as follows: ≤1 day (28.5%); ≤1 week (13.8%); >1 week but ≤1 month (10.5%), and >1 month (47.2%). Most common etiologies were degenerative conditions (30.8%), malignant tumors (16.2%), ischemia (10.9%), benign tumors (8.7%), and bacterial infections (7.1%). Most patients (72.3%) had paraplegia. The AIS grade on SRU admission was grade A in 14%, grade B in 6.5%, grade C in 24%, grade D in 52.4%, grade E in 0.2%, and missing in 2.9%. AIS grade significantly improved by discharge (z=-10.1, P<.0001). Median length of stay in the SRU was 46.5 days (IQR, 17-89.5). Most (80.5%) patients were discharged home. Differences between countries were found for most variables. CONCLUSIONS: This international study of spinal cord dysfunction showed substantial variation of etiology, demographic, and clinical characteristics across countries. Further research, including multiple centers per country, are needed to separate country effects from center effects.
DOI: 10.1016/j.apmr.2015.02.016
PubMed URL:
ISSN: 0003-9993
Journal Title: Archives of Physical Medicine and Rehabilitation
Type: Journal Article
Affiliated Organisations: Epworth-Monash Rehabilitation Medicine Unit, Monash University, Melbourne, Victoria, Australia
Spinal Rehabilitation Service, Caulfield Hospital, Alfred Health, Melbourne, Victoria, Australia
Department of Physical Medicine and Rehabilitation, Mayo Clinic College of Medicine, Rochester, MN
National Rehabilitation and Mater Misericordiae University Hospitals, Dublin, Ireland
GF Strong Rehabilitation Centre, Vancouver, BC, Canada
University of British Columbia, Vancouver, Canada
Swiss Paraplegic Research, Swiss Paraplegic Centre, Nottwil, Switzerland
Neurological Rehabilitation Department, National Institute of Mental Health and Neurological Sciences, Bangalore, India
National Spinal Injuries Centre, Stoke Mandeville Hospital, Aylesbury, Buckinghamshire, UK
Institute of Hospitalization and Scientific Care (IRCCS) Fondazione S. Lucia, Rome, Italy
Brain Center Rudolf Magnus and Center of Excellence in Rehabilitation Medicine, University Medical Center Utrecht and De Hoogstraat, Utrecht, The Netherlands
Type of Clinical Study or Trial: Retrospective studies
Appears in Collections:Neurosciences

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