Incidence and severity of acute complications after spinal cord injury

Grossman, Robert G.; Frankowski, Ralph F.; Burau, Keith D.; Toups, Elizabeth G.; Crommett, John; Johnson, Mai; Fehlings, Michael G.; Tator, Charles H.; Shaffrey, Christopher I.; Harkema, Susan J.; Hodes, Jonathan E.; Aarabi, Bizhan; Rosner, Michael; Guest, James D.; Harrop, James S.

doi:10.3171/2012.5.aospine12127

Cited by 118 publications

(94 citation statements)

References 19 publications

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“…The consequences of pressure ulcers include increased LOS, re-hospitalization and increased rehabilitation expenses. Pressure ulcers are also a common cause of death to persons with spinal cord injury in many lower income countries [4,14,31]. The magnitude of pressure ulcers, respiratory complications and urinary tract infections partly explain the high in-hospital mortality of 24.4% of all TSCI admissions [32].…”

Section: Discussionmentioning

confidence: 99%

Traumatic spinal cord injury in the north-east Tanzania – describing incidence, etiology and clinical outcomes retrospectively

Moshi

Sundelin

Sahlén

et al. 2017

Global Health Action

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Background: Causes, magnitude and consequences of traumatic spinal cord injury depend largely on geography, infrastructure, socioeconomic and cultural activities of a given region. There is a scarcity of literature on profile of traumatic spinal cord injury to inform prevention and rehabilitation of this health condition in African rural settings, particularly Tanzania. Objective: To describe the incidence, etiology and clinical outcomes of traumatic spinal cord injury and issues related to retrospective study in underdeveloped setting. Methods: Records for patients with traumatic spinal cord injury for five consecutive years (2010–2014) were obtained retrospectively from the admission wards and health records archives of the Kilimanjaro Christian Medical Center. Sociodemographic, cause, complications and patients’ condition on discharge were recorded and analyzed descriptively. Results: The admission books in the wards registered 288 new traumatic spinal cord injury cases from January 2010 to December 2014. Of the 288 cases registered in the books, 224 were males and 64 females with mean age 39.1(39.1 ± 16.3) years and the majority of individuals 196(68.1%) were aged between 16 and 45 years. A search of the hospital archives provided 213 full patient records in which the leading cause of injury was falls 104(48.8%) followed by road traffic accidents 73(34.3%). Cervical 81(39.9%) and lumbar 71(34.74%) spinal levels were the most affected. The annual incidence for the Kilimanjaro region (population 1,640,087) was estimated at more than 26 persons per million population. The most documented complications were pressure ulcers 42(19.7%), respiratory complications 32(15.0%) and multiple complications 28(13.1%). The mean length of hospital stay was 64.2 ± 54.3 days and the mortality rate was 24.4%. Conclusion: Prevention of traumatic spinal cord injury in North-east Tanzania should consider falls (particularly from height) as the leading cause, targeting male teenagers and young adults. Pressure ulcers, respiratory complications, in-hospital mortality and availability of wheelchairs should be addressed.

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Section: Discussionmentioning

confidence: 99%

Traumatic spinal cord injury in the north-east Tanzania – describing incidence, etiology and clinical outcomes retrospectively

Moshi

Sundelin

Sahlén

et al. 2017

Global Health Action

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“…18 Participants less than 1 month following injury were grouped as 'acute' because this typically represents a period of catabolic stress brought about by surgical intervention, 19 increased prevalence of complications 20 and negative nitrogen balance coinciding with weight loss. 21 Patients between one and six months after injury were grouped as 'sub-acute.'…”

Section: Charting Data According To Key Conceptsmentioning

confidence: 99%

Investigation of measured and predicted resting energy needs in adults after spinal cord injury: a systematic review

et al. 2015

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Background: Accurate estimation of energy needs is vital for effective nutritional management of individuals with spinal cord injury (SCI). Inappropriate energy prescription after SCI can compound the rates of malnutrition or obesity, increase the risk of complications and negatively influence outcomes. Energy requirements following SCI are not well understood, and there is currently no universally accepted method of estimating energy needs in clinical practice. Study design: This is a systematic literature review. Objectives: The objectives of this study were to investigate and compare the measured resting energy needs of adults with SCI across different phases of rehabilitation, and to identify appropriate energy prediction equations for use in SCI. Setting: This study was conducted in Australia. Methods: MEDLINE, EMBASE and CENTRAL databases were searched for studies published between 1975 and April 2015, identifying 298 articles. Full articles in English language of adults with SCI who were fasted for a minimum of 8 hours before undergoing indirect calorimetry to measure resting energy expenditure (REE) for at least 20 min were selected. On the basis of the inclusion criteria, 18 articles remained for data extraction. One author extracted information from all articles, and inter-rater reliability was tested in five articles. Results: REE across three phases of injury was assessed: acute, sub-acute and chronic. Few studies (n = 2) have investigated REE in the acute and sub-acute injury stages of SCI recovery. The factors influencing chronic energy needs in SCI patient populations are many and varied, and a valid predictive equation for use in SCI remains elusive. SCI is initially associated with catabolic conditions of trauma such as spinal shock and patients may be at risk of weight loss, malnutrition and pressure injuries. 1 In the long term, SCI results in marked body composition changes, specifically muscle atrophy below the level of injury and higher relative fat mass compared with people without SCI, 1-3 which may contribute to decreases in resting energy expenditure (REE). In an environment of reduced mobility, energy needs are further reduced, and there is an increased risk of weight gain and obesity-related chronic diseases. 4,5 To prescribe an appropriate daily energy intake, an individual's total daily energy expenditure (TDEE) must be determined. An individual's TDEE comprises three components, two of which may be considerably affected by SCI. Basal metabolic rate (BMR) is the minimum energy required for the basal processes of life, and it contributes the majority (~70%) of TDEE in a healthy person. 6 In the clinical literature, the term BMR is often used interchangeably with REE, and for the purpose of this review REE is defined as the energy expended in an awake, alert individual in a rested position following

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“…Individuals with SCI have a high lifelong risk for debilitating and costly medical conditions, such as urinary tract infections, pressure ulcers, pain, spasticity, increased body mass index, respiratory and cardiac complications, depression and psychosocial outcomes (2)(3)(4)(5)(6)(7)(8).…”

Section: Introductionmentioning

confidence: 99%

Effective Teaching Strategies for Patient Education in Individuals With Spinal Cord Injury in Iran

Khazaeipour

2016

Arch Neurosci

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Background: Spinal cord injury (SCI) causes multiple complications, which can be prevented or minimized, through patient education (PE). Individuals with SCI are different, according to culture, socioeconomic status, level of education, access to educational facilities, and geographic region. Therefore, different teaching strategies should be used to increase effectiveness of education. Objectives: The aim of this study is to evaluate the perspectives of individuals with SCI, about their preferred methods of PE. Patients and Methods:This was a descriptive cross-sectional study undertaken at the brain and spinal cord injury research center (BASIR), Tehran university of medical sciences, Tehran, Iran. The participants comprised of 119 SCI persons (81 men and 38 women), with mean age of 32 ± 10.5 years, referred to BASIR clinic to receive outpatient rehabilitation, in 2012. The patients were asked about their views, concerning preferred methods of PE. Results: Most participants (94%) appreciated to be informed concerning their illness. The two most preferred education methods were educational movies by CD or DVD (44%) and lectures or face classes (36%), followed by educational TV programs (30%), brochures (24%), education via internet or computer-aided (14.3%), and, finally, educational books (2%). Conclusions: Health care providers should take into account the differences between individuals with SCI, to use effective teaching strategies. Also, they should apply appropriate teaching methods and more than one teaching strategy, in relation to the different time and situation. Effective PE, in individuals with SCI, can increase their knowledge and motivation in self-care, improve satisfaction, prevent complications and make the PE more effective.

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Incidence and severity of acute complications after spinal cord injury

Cited by 118 publications

References 19 publications

Traumatic spinal cord injury in the north-east Tanzania – describing incidence, etiology and clinical outcomes retrospectively

Traumatic spinal cord injury in the north-east Tanzania – describing incidence, etiology and clinical outcomes retrospectively

Investigation of measured and predicted resting energy needs in adults after spinal cord injury: a systematic review

Effective Teaching Strategies for Patient Education in Individuals With Spinal Cord Injury in Iran

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