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Title: International retrospective comparison of inpatient rehabilitation for patients with spinal cord dysfunction: differences according to etiology
Epworth Authors: New, Peter
Other Authors: Reeves, Ronald K.
Smith, Eimear
Eriks-Hoogland, Inge
Gupta, Anupam
Scivoletto, Giorgio
Townson, A.
Maurizio, Belci
Post, Marcel
Keywords: Epidemiology
Outcome and Process Assessment
Spinal Cord Diseases
Spinal Cord Injuries
Spinal Cord Dysfunction
Demographic Characteristics
American Spinal Injury Association Impairment Scale
Spinal Rehabilitation Units
Epworth-Monash Rehabilitation Medicine Unit, Monash University, Melbourne, Victoria, Australia.
Issue Date: Mar-2016
Publisher: Elsevier
Citation: Arch Phys Med Rehabil. 2016 Mar;97(3):380-5
Abstract: OBJECTIVES: To describe and compare epidemiologic characteristics and clinical outcomes of patients with nontraumatic spinal cord dysfunction according to etiology. DESIGN: Retrospective, multicenter open-cohort case series. SETTING: Spinal rehabilitation units (SRUs) in 9 countries. PARTICIPANTS: Patients (N=956; men, 60.8%; median age, 59.0y [interquartile range, 46-70.0y]; paraplegia, n=691 [72.3%]) with initial onset of spinal cord dysfunction consecutively admitted between January 1, 2008, and December 31, 2010. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Etiology of spinal cord dysfunction, demographic characteristics, length of stay (LOS) in rehabilitation, pattern of spinal cord dysfunction onset, discharge destination, level of spinal cord damage, and the American Spinal Injury Association Impairment Scale (AIS) grade on admission and discharge. RESULTS: The most common etiologies were degenerative (30.8%), malignant tumors (16.2%), infections (12.8%), ischemia (10.9%), benign tumors (8.7%), other vascular (8.5%), and other conditions (12.1%). There were major differences in epidemiologic characteristics and clinical outcomes of patients with different etiologies of spinal cord dysfunction. Paraplegia was more common in patients with a malignant tumor and vascular etiologies, while tetraplegia was more common in those with a degenerative etiology, a benign tumor, and infections. Patients with a malignant tumor tended to have the shortest LOS in the SRU, while those with a vascular etiology tended to have the longest. Except for patients with a malignant tumor, all patient groups had a significant change in their AIS grade between admission and discharge. CONCLUSIONS: This international study of spinal cord dysfunction showed substantial variation between the different etiologies regarding demographic and clinical characteristics, including changes in AIS between admission and discharge.
DOI: 10.1016/j.apmr.2015.10.107
PubMed URL:
ISSN: 0003-9993
Journal Title: Archives of Physical Medicine and Rehabilitation
Type: Journal Article
Affiliated Organisations: Spinal Rehabilitation Service, Caulfield Hospital, Alfred Health, Caulfield, Victoria, Australia
Department of Physical Medicine and Rehabilitation, Mayo Clinic College of Medicine, Rochester, MN.
National Rehabilitation and Mater Misericordiae University Hospitals, Dublin, Ireland.
Swiss Paraplegic Research, Swiss Paraplegic Center, Nottwil, Switzerland.
Neurological Rehabilitation Division, Department of Psychiatric and Neurological Rehabilitation, National Institute of Mental Health and Neurological Sciences, Bangalore, India.
Institute of Hospitalization and Scientific Care Fondazione S. Lucia, Rome, Italy.
GF Strong Rehab Center, Vancouver, British Columbia, Canada; University of British Columbia, Vancouver, British Columbia, Canada.
National Spinal Injuries Center, Stoke Mandeville Hospital, Aylesbury, Buckinghamshire, United Kingdom.
Rudolf Magnus Institute of Neuroscience and Center of Excellence in Rehabilitation, University Medical Center Utrecht and De Hoogstraat, Utrecht, The Netherlands; University of Groningen, University Medical Center Groningen, Center for Rehabilitation, Groningen, The Netherlands.
Type of Clinical Study or Trial: Retrospective studies
Appears in Collections:Neurosciences

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