Functional Outcome in Trauma Patients With Spinal Injury

Akmal, Mohammad; Trivedi, Rikin; Sutcliffe, J. C.

doi:10.1097/00007632-200301150-00016

Cited by 38 publications

(30 citation statements)

References 21 publications

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“…21 FIM scores alone are not an appropriate predictor of employment, because factors such as motivation and finances can influence the score. 22 Although not statistically significant, our cases reported higher motivational levels and less dependence on benefits, which were also reflected in the qualitative findings; this affirms the potential predictive value of FIM motor subscale scores within this sample.…”

Section: Mixed-methods View Of Facilitators To Employmentsupporting

confidence: 69%

Facilitators and Barriers to Employment Among Veterans with Spinal Cord Injury Receiving 12 Months of Evidence-Based Supported Employment Services

Cotner

Njoh

Trainor

et al. 2015

Topics in Spinal Cord Injury Rehabilitation

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Background:Return to work is associated with positive rehabilitation outcomes for persons with spinal cord injury (SCI); however, more research is needed on vocational support for persons with disabilities seeking employment. Objective: The association between facilitators and barriers of employment and employment outcome was examined among Veterans with SCI who participated in an evidence-based supported employment (EBSE) program. Methods: Using a mixed-methods, nested case-control design, data on facilitators and barriers to employment were extracted from qualitative interviews and quantitative measures administered in person to 34 Veterans with SCI who completed 12 months of an EBSE program. Participants who did (case) and did not (control) obtain competitive employment were matched on time since SCI. Facilitators and barriers to employment were compared between the groups. Results: Self-report measures administered at baseline were examined; there were no statistically significant factors that predicted employment outcomes after 12 months of EBSE program participation. Qualitative interview data revealed program-specific facilitators and Veteran characteristics that were associated with employment outcomes. Conclusions: Qualitative data illustrate how the integration of the vocational rehabilitation specialist on the medical team is helpful for addressing identified disability-specific barriers, including practical matters such as transportation and caregiving schedules, to facilitate employment outcomes.

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Section: Mixed-methods View Of Facilitators To Employmentsupporting

confidence: 69%

Facilitators and Barriers to Employment Among Veterans with Spinal Cord Injury Receiving 12 Months of Evidence-Based Supported Employment Services

Cotner

Njoh

Trainor

et al. 2015

Topics in Spinal Cord Injury Rehabilitation

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“…Odontoid peg fractures in the elderly are the most common and serious injury. This can be a significant source of morbidity and mortality in all age groups [2,15,17]. It is the most frequent individual fracture of the cervical spine in person aged 65 years and older [1, 7, 10-14, 16, 18].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of morbidity, mortality and outcome following cervical spine injuries in elderly patients

et al. 2008

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We analysed the morbidity, mortality and outcome of cervical spine injuries in patients over the age of 65 years. This study was a retrospective review of 107 elderly patients admitted to our tertiary referral spinal injuries unit with cervical spine injuries between 1994 and 2002. The data was acquired by analysis of the national spinal unit database, hospital inpatient enquiry system, chart and radiographic review. Mean age was 74 years (range 66-93 years). The male to female ratio was 2.1:1 (M = 72, F = 35). The mean follow-up was 4.4 years (1-9 years) and mean in-hospital stay was 10 days (2-90 days). The mechanism of injury was a fall in 75 and road traffic accident in the remaining 32 patients. The level involved was atlanto-axial in 44 cases, sub-axial in 52 cases and the remaining 11 had no bony injury. Multilevel involvement occurred in 48 patients. C2 dominated the single level injury and most of them were type II odontoid fractures. Four patients had complete neurology, 27 had incomplete neurology, and the remaining 76 had no neurological deficit. Treatment included cervical orthosis in 67 cases, halo immobilization in 25, posterior stabilization in 12 patients and anterior cervical fusion in three patients. The overall complication rate was 18.6% with an associated in-hospital mortality of 11.2%. The complications included loss of reduction due to halo and Minerva loosening, non-union and delayed union among conservatively treated patients, pin site and wound infection, gastrointestinal bleeding and complication due to associated injuries. Among the 28.9% patients with neurological involvement, 37.7% had significant neurological recovery. Outcome was assessed using a cervical spine outcome questionnaire from Johns Hopkins School of Medicine. Sixty-seven patients (70%) completed the form, 20 patients (19%) were deceased at review and 8 patients (7%) were uncontactable. Functional disability was more marked in the patients with neurologically deficit at time of injury. Outcome of the injury was related to increasing age, co-morbidity and the severity of neurological deficit. Injuries of the cervical spine are not infrequent occurrence in the elderly and occur with relatively minor trauma. Neck pain in the elderly patients should be thoroughly evaluated to exclude C2 injuries. Most patients can be managed in an orthosis but unstable injuries require rigid external immobilization or surgical stabilization.

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“…Differences in incidence rates between countries are likely to relate to a variety of factors, including socioeconomic and geographic differences, but may also reflect heterogeneity in reporting and coding practices. Predominantly affecting males [2,3], traumatic SCI is primarily caused by motor vehicle collision [2,[4][5][6][7] and falls [3,8,9]. With changing demographic trends and injury patterns, the proportion of neck injuries causing a cervical SCI (CSCI) is reported to be growing (around 55-60% of all traumatic SCIs), whilst the incidence of neurologically complete lesions is reducing [10].…”

Section: Introductionmentioning

confidence: 99%

Should suspected cervical spinal cord injury be immobilised?: A systematic review

Oteir

Smith

Stoelwinder

et al. 2015

Injury

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Functional Outcome in Trauma Patients With Spinal Injury

Abstract: Most of the patients had poor initial Functional Independence Measure scores, but there was significant improvement by 12 months. Discharge FIM scores were a good indicator for functional outcome at one year.

Cited by 38 publications

References 21 publications

Facilitators and Barriers to Employment Among Veterans with Spinal Cord Injury Receiving 12 Months of Evidence-Based Supported Employment Services

Facilitators and Barriers to Employment Among Veterans with Spinal Cord Injury Receiving 12 Months of Evidence-Based Supported Employment Services

Evaluation of morbidity, mortality and outcome following cervical spine injuries in elderly patients

Should suspected cervical spinal cord injury be immobilised?: A systematic review

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