Characteristics, length of stay and functional outcome of patients with spinal cord injury in Dutch and Flemish rehabilitation centres

Abstract

Study design: Multi-centre prospective descriptive study. Objective: To establish a profile of the population affected with traumatic and non-traumatic spinal cord injury (SCI) admitted to rehabilitation centres in the Netherlands and Flanders (Belgium) and to describe determinants of length of stay (LOS) and functional outcome. Methods: Information about LOS, functional outcome and personal and injury characteristics was derived from a joint data set developed for this project. Results: A total of 54.7% of patients with SCI had a non-traumatic lesion. The group of patients with non-traumatic SCI showed a more even gender distribution, a more advanced age and less severe lesion characteristics than the group of patients with traumatic SCI. Linear regression models explained 32% of the variance of LOS and 42% of the variance of functional outcome. Functional status on admission was the strongest determinant of LOS and completeness of the lesion was the strongest determinant of functional outcome. Aetiology (traumatic versus non-traumatic) was a weak independent determinant of LOS but was not an independent determinant of functional outcome. Conclusion: Patients with non-traumatic SCI formed a majority in the Dutch and Flemish SCI population. Although the characteristics of patients with traumatic and non-traumatic SCI clearly differed, rehabilitation of patients with non-traumatic SCI appears at least as efficient as rehabilitation of patients with traumatic SCI.

Comparison of patients managed in specialised spinal rehabilitation units with those managed in non-specialised rehabilitation units

“…The finding that there were more patients with NT-SCI admitted to rehabilitation reinforces results from recent research in Australia, 10 and elsewhere, 19,20 that in developed countries the incidence of NT-SCI is greater than T-SCI. Our results also suggest that the Australian Spinal Cord Injury Register 21,22 does not capture all T-SCI patients in Australia.…”

Traumatic and non-traumatic spinal cord lesions: an Italian comparison of neurological and functional outcomes

“…McKinley et al 16 also reported that non-traumatic patients could have significant improvement after the rehabilitation treatment; however, when compared with traumatic patients, they achieve lower overall functional gains, but have a shorter LOS. Accordingly to these data, Osterthun et al 11 reported that etiology was not a determinant of functional outcome of patients with SCLs.…”

“…However, in spite of the high incidence of non-traumatic lesions, which is considered to vary between 25 and 80% of the total admission for spinal cord injuries, there are still few studies on the influence of different etiologies (namely traumatic vs non-traumatic) on SCL outcome; [5][6][7][8][9][10][11] this is probably due to the different features of the two populations with regard to age, lesion severity and lesion to admission time (LTA), which are wellknown prognostic factors: 5 therefore, the two groups of patients are poorly comparable.…”

Causes of death following spinal cord injury during inpatient rehabilitation and the first five years after discharge. A Dutch cohort study

“…11 Considering the generalisation of our results, the participants of this study were on average younger, had more often a complete and traumatic SCI than persons with SCI admitted to Dutch and Flemish rehabilitation centres. 19 The inclusion criteria of our study thus render a positive selection and, consequently, probably an underestimation of mortality compared with the Dutch SCI population.…”