Risk indicators of length of acute hospital stay after traumatic spinal cord injury in South Africa: a prospective, population-based study

Conradsson, David; Phillips, Julie; Nizeyimana, Eugene; Hilliar, Chantal; Joseph, Conran

doi:10.1038/s41393-019-0286-0

Cited by 10 publications

(7 citation statements)

References 28 publications

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“…The length of hospitalisation was greater in patients with UTI, which was consistent with other studies (Conradsson et al, 2019;Evans et al, 2008;Goodes et al, 2020;Sekulic et al, 2015).…”

Section: Relationships Between Length Of Hospitalisation and Utisupporting

confidence: 91%

Incidence and risk factors of urinary tract infections in hospitalised patients with spinal cord injury

Kim

Cho

et al. 2021

Journal of Clinical Nursing

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Aims and objectives: To investigate the incidence of urinary tract infection and analyse its risk factors among hospitalised patients with spinal cord injury.Background: While the incidence of urinary tract infection varies widely according to the healthcare setting and patients' clinical characteristics, formal reports are limited in quantity. There has been no consensus regarding the risk factors for urinary tract infection.Design: A retrospective descriptive study.Methods: Electronic medical records of 964 subjects between 2010-2017 were reviewed. Urinary tract infection status was examined to identify newly occurred cases.Data included demographic and clinical characteristics, hydration status and length of hospitalisation. The reporting of the study followed the EQUATOR Network's STROBE checklist.Results: Of the sample, 31.7% had urinary tract infection (95% confidence interval:1.288 to 1.347, p < .001). Sex, completeness of injury, type of bladder emptying, detrusor function and urethral pressure were significant factors affecting urinary tract infection. Patients who were male and those with injury classifications A, B and C had higher risk of urinary tract infection. Patients with urinary or suprapubic indwelling catheters, as well as those with areflexic detrusor combined with normotonic urethral pressure or overactive detrusor combined with normotonic urethral pressure, showed higher risk. Length of hospitalisation in patients with urinary tract infection was greater than that in uninfected patients, which implies the importance of prevention of urinary tract infection. Conclusions: Nurses should carefully assess risk factors to prevent urinary tract infection in patients with spinal cord injury in the acute and sub-acute stages of the disease trajectory and provide individualised nursing care. Relevance to clinical practice: This study contributes evidence for up-to-date clinical nursing practice for the comprehensive management of urinary tract infection. This can lead to improvements in nursing care quality and patient outcomes, including length of hospitalisation. | 2069 KIM et al. | INTRODUC TI ONUrinary tract infection (UTI) is currently the most common infection following spinal cord injury (SCI) (

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“…The length of hospitalisation was greater in patients with UTI, which was consistent with other studies (Conradsson et al, 2019;Evans et al, 2008;Goodes et al, 2020;Sekulic et al, 2015).…”

Section: Relationships Between Length Of Hospitalisation and Utisupporting

confidence: 91%

Incidence and risk factors of urinary tract infections in hospitalised patients with spinal cord injury

Kim

Cho

et al. 2021

Journal of Clinical Nursing

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“…Those who had not died faced ongoing problems with pressure injuries, social isolation, lack of employment, poverty and depression [ 3 ]. Similar findings have been reported in other LMICs [ 4 – 7 ]. So clearly there is an urgent need to support people with SCI in the community particularly in the first few years post discharge.…”

Section: Introductionsupporting

confidence: 92%

Understanding how a community-based intervention for people with spinal cord injury in Bangladesh was delivered as part of a randomised controlled trial: a process evaluation

et al. 2020

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Design Mixed methods study Setting Community, Bangladesh Objectives To understand how a community-based intervention for people with spinal cord injury (SCI) in Bangladesh was delivered as part of a randomised controlled trial and to gauge the perceptions of participants and healthcare professionals to the intervention. Methods A community-based intervention was administered to 204 participants as part of a large randomised controlled trial (called the CIVIC trial). Case-managers followed-up participants with regular telephone calls and home visits over the first 2 years after discharge. The following data were collected alongside the trial: (i) chart audit of telephone calls and home visits (ii) recordings of 20 telephone calls (iii) interviews with 14 Intervention participants and four healthcare professionals including three case-managers. Results Participants received the target number of telephone calls and home visits. Pressure injuries were identified as a problem during at least one telephone call by 43% of participants. Participants and case-managers valued regular telephone calls and home visits, and believed that calls and visits prevented complications and alleviated social isolation. Participants trusted case-managers and were confident in the care and advice provided. Case-managers expressed concerns that people with SCI in Bangladesh face many problems impacting on well-being and motivation stemming from poverty, limited employment opportunities, societal attitudes and inaccessible environments. Conclusion A community-based intervention involving regular telephone calls and home visits was administered as intended and was well received by the recipients of the care. Nonetheless, people with SCI in Bangladesh face economic and social problems which cannot be fully addressed by this type of intervention alone.

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“…However, hospital LOS is associated with a combination of factors including socioeconomic factors, disposition issues, and injury characteristics including ISS, which was higher at L2TCs. 31,32 In addition, there was no difference observed in ICU LOS between the 2 groups. L2TCs and L3TCs both serve necessary functions and are fully capable of treating the patients that they receive.…”

Section: Discussionmentioning

confidence: 84%

Injury and Mortality Profiles in Level II and III Trauma Centers

Farhat

Grigorian

Farhat

et al. 2021

The American Surgeon

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Background While the benefit of admission to trauma centers compared to non-trauma centers is well-documented and differences in outcomes between Level-I and Level-II trauma centers are well-studied, data on the differences in outcomes between Level-II trauma centers (L2TCs) and Level-III trauma centers (L3TCs) are scarce. Objectives We sought to compare mortality risk between patients admitted to L2TCs and L3TCs, hypothesizing no difference in mortality risk for patients treated at L3TCs compared to L2TCs. Methods A retrospective analysis of the 2016 Trauma Quality Improvement Program (TQIP) database was performed. Patients aged 18+ years were divided into 2 groups, those treated at American College of Surgeons (ACS) verified L2TCs and L3TCs. Results From 74,486 patients included in this study, 74,187 (99.6%) were treated at L2TCs and 299 (.4%) at L3TCs. Both groups had similar median injury severity scores (ISSs) (10 vs 10, P < .001); however, L2TCs had a higher mean ISS (14.6 vs 11.9). There was a higher mortality rate for L2TC patients (6.0% vs 1.7%, P = .002) but no difference in associated risk of mortality between the 2 groups (OR .46, CI .14-1.50, P = .199) after adjusting predictors of mortality. L2TC patients had a longer median length of stay (5.0 vs 3.5 days, P < .001). There was no difference in other outcomes including myocardial infarction (MI) and cerebrovascular accident (CVA) ( P > .05). Discussion Patients treated at L2TCs had a longer LOS compared to L3TCs. However, after controlling for covariates, there was no difference in associated mortality risk between L2TC and L3TC patients.

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Risk indicators of length of acute hospital stay after traumatic spinal cord injury in South Africa: a prospective, population-based study

Cited by 10 publications

References 28 publications

Incidence and risk factors of urinary tract infections in hospitalised patients with spinal cord injury

Incidence and risk factors of urinary tract infections in hospitalised patients with spinal cord injury

Understanding how a community-based intervention for people with spinal cord injury in Bangladesh was delivered as part of a randomised controlled trial: a process evaluation

Injury and Mortality Profiles in Level II and III Trauma Centers

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