Complications and costs of management of acute spinal cord injury

Tator, Charles H.; Duncan, E. G.; Edmonds, Virginia E.; Lapczak, L I; Andrews, D. F.

doi:10.1038/sc.1993.112

Cited by 63 publications

(46 citation statements)

References 11 publications

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“…15,34 In the present study, we noted that a number of medical complications in individuals with NTSCL correlated with length of stay in rehabilitation unit. Patients with tetraplegia and more severe disability tended to have more complications.…”

Section: Discussionsupporting

confidence: 50%

Nontraumatic spinal cord lesions: a prospective study of medical complications during in-patient rehabilitation

et al. 2005

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Section: Discussionsupporting

confidence: 50%

Nontraumatic spinal cord lesions: a prospective study of medical complications during in-patient rehabilitation

et al. 2005

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“…23 As shown in another recently published companion study the major reason for the reduced LOS in the ASCIU group was the reduction in complications. 24 Heinemann et a/4 also found a decreased LOS in the acute phase for patients treated initially in an ASCIU.…”

Section: Discussionmentioning

confidence: 93%

Neurological recovery, mortality and length of stay after acute spinal cord injury associated with changes in management

Tator¹,

Duncan²,

Edmonds³

et al. 1995

Spinal Cord

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Based on epidemiological data from two populations of patients with acute spinal cord injury (ASCI), three outcome measures were compared to evaluate the effectiveness of management of ASCI patients in a regional, specialized acute spinal cord injury unit (ASCIU). The two populations consisted of a pre-ASCIU group of 351 patients managed from 1947-73 before the establishment of the ASCIU, and an ASCIU group of 201 patients managed in an ASCIU from 1974-81. The three outcome measures were mortality rate, length of stay (LOS) during first hospitalization, and neurological recovery. Linear regression and multiple regression analyses were used to determine whether differences in the outcome measures were attributable to differences in admission variables in addition to the influence of the ASCIU.The results showed that the patients treated in the ASCIU had a significant reduction in the mortality rate of almost 50% (P = 0.022), a significant reduction in the LOS of almost 50% (P < 0.001), and a significant increase in neurological recovery consisting of a doubling of the neurological recovery scale utilized (P < 0.001). Multiple regression analysis showed that the reduction in mortality rate was significantly influenced by differences in the admission variables between the two groups. However, the establishment of the ASCIU was associated with a significant reduction in LOS and a significant improvement in neurological recovery. Thus, these results support the view that manage ment of ASCI patients in a regional, multidisciplinary unit is medically advantageous and can reduce the LOS.

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“…IO -14 Other facility-specific studies include a pair of studies from Independent Living Centers in Boston and Worcester, MA 17.I S and a contribution from Toronto Canada. 16 Again, these works focus on describing the experiences of specialized SCI treatment centers.…”

Section: Correspondence: Rl Johnsonmentioning

confidence: 99%

Cost of traumatic spinal cord injury in a population-based registry

1996

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This prospective study examines a population based cohort of 115 Coloradans identified as having an acute traumatic spinal cord injury by the Spinal Cord Injury Early Notification System in 1989. Comprehensive medical cost and complication data were collected for the first 2 years of survival. Unlike previous cost studies, this group represents the broad spectrum of spinal cord injured persons, reflected in a truly population based sample. Nearly 22 million dollars were spent during the first 2 years post injury on behalf of these Coloradans. Care provided to the 27 persons with Frankel A, B or C tetraplegia accounted for $10.9 million (50%); $7.6 million (35%) was spent providing care for the 36 people with Frankel A, B or C paraplegia; and the remaining $3.3 million (15%) was required for services provided to the 52 persons who had resolved to either Frankel D or E at acute care discharge. Of the $6.3 million that was spent post hospital discharge, $2.5 million (39%) is directly attributable to in-home care, and another $2.0 million (32%) is directly attributable to secondary medical complications. The most expensive complications occurred in the neurological, skin, respiratory and orthopedic body systems.

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Complications and costs of management of acute spinal cord injury

Cited by 63 publications

References 11 publications

Nontraumatic spinal cord lesions: a prospective study of medical complications during in-patient rehabilitation

Nontraumatic spinal cord lesions: a prospective study of medical complications during in-patient rehabilitation

Neurological recovery, mortality and length of stay after acute spinal cord injury associated with changes in management

Cost of traumatic spinal cord injury in a population-based registry

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