Spinal cord injury in Italy: A multicenter retrospective study

Celani, Maria Grazia; Spizzichino, Lorenzo; Ricci, Stefano; Zampolini, Mauro; Franceschini, Marco

doi:10.1053/apmr.2001.21948

Cited by 92 publications

(88 citation statements)

References 21 publications

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“…21 According to some studies 19,22 motor vehicle accidents in young patients were the leading cause of SCI followed by falls, sport accidents, suicide attempts and acts of violence. These data are similar to those of other Italian statistics, 23 but different from USA data in which acts of violence have become the second cause of injuries 3 and the leading cause in paraplegic subjects. 7 The distribution of nontraumatic lesions is also comparable to McKinley's report 20 with vertebral degenerative disease as having the highest association with spinal cord disease.…”

Section: Discussionsupporting

confidence: 87%

Effects on age on spinal cord lesion patients' rehabilitation

et al. 2003

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Study design: The present study was undertaken to focus the age-related characteristics of a population of traumatic and nontraumatic spinal cord patients. Objectives: to examine demographic, injury and outcome characteristics of older adults with spinal cord lesions as a result of trauma and nontrauma, and to compare these characteristics with those of younger patients in matched cohorts. Setting: Spinal Cord Unit, Fondazione Santa Lucia IRCCS, a large rehabilitation hospital of the centre-south of Italy. Methods: In total, 284 consecutive newly injured patients with traumatic and nontraumatic spinal cord lesions were retrospectively reviewed and divided according to age into two groups: under 50 years (group 1) and over 50 years (group 2). The following information was collected: onset of lesion to admission; injury variables: aetiology, level, associated injuries, medical complications and surgical intervention; length of stay; American Spinal Injury Association (ASIA) impairment and motor scores; Barthel Index (BI) and Rivermead Mobility Index (RMI) to assess independence in daily living; Walking Index for Spinal Cord Injury to assess ambulation; patients destination at discharge. In a subset of 130 subjects, a block design, matching procedure was used to control for the covariant effects of injury characteristics, time from lesion and aetiology on age effects. Results: In the entire group of 284 patients, older subjects had a higher probability of having incomplete tetraplegia of nontraumatic origin; they also showed a shorter length of stay and a higher rate of complications. In the matched cohorts, younger patients showed better neurologic recovery (intended as ASIA impairment grade improvement and motor scores increase), significantly higher Barthel Index and RMI at discharge, a higher level of independence in spontaneous bladder and bowel management and a higher frequency of independent walking. Conclusion: Older individuals with spinal cord injury and disease do well, but have a less favourable outcome in regard to walking, bladder and bowel independence than younger subjects and have more associated medical problems. Different rehabilitative strategies, therefore, are required for older subjects, which maximises the shorter length of stay and provides the necessary medical care and increased physical assistant resources following discharge.

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Section: Discussionsupporting

confidence: 87%

Effects on age on spinal cord lesion patients' rehabilitation

et al. 2003

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“…LOS in this study was longer than those reported in studies from the United States (mean 60.8 days), 14 Australia (median 83 days), 15 Italy (mean 143.1 for traumatic and 91.7 days for non-traumatic injuries) 8 and a previous retrospective Dutch Characteristics of Dutch and Flemish patients with SCI R Osterthun et al study. 7 It was more or less comparable to LOS in Israel 16 and shorter than that reported in Japan.…”

Section: Length Of Staycontrasting

confidence: 56%

“…2,7-9,12,13 Percentages of women reported in the literature (36.6-58%) also resembled our findings, as did those for paraplegia (63.6-82.5%) and incomplete lesions (68.6-91%). 2,[7][8][9]12,13 The most common non-traumatic aetiologies in this study were vascular diseases, spinal degeneration and tumours (benign and malignant), which all accounted for over a quarter of non-traumatic lesions. Tumours and spinal degeneration were also a substantial category of nontraumatic SCI in other studies (20.1-36.4% 2,8,9,12,13 and 18-29%, 2,7,12,13 respectively).…”

Section: Traumatic Scimentioning

confidence: 85%

“…7 Lower percentages were found in studies from Turkey (32.5%), 2 Italy (25%) 8 and the United States (39%). 9 This difference might be attributed to the low incidence of traumatic SCI in the Netherlands 3 or to a greater readiness of specialized Dutch rehabilitation centres to admit patients with non-traumatic SCI compared to rehabilitation centres elsewhere.…”

Section: Traumatic Versus Non-traumatic Scimentioning

confidence: 89%

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

2008

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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.

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“…[1][2][3][4][5][6][7] The relation between traumatic and nontraumatic SCL differs between investigations. The nontraumatic SCL have been reported to comprise 25% of all SCL in studies performed in Italy 8 and Germany, 9 35% in England, 10 39% in the US, 3 and 46% in Fiji. 11 As for traumatic spinal cord injury, long-standing neuropathic pain is considered to be one of the most challenging problems after non-traumatic SCL.…”

Section: Introductionmentioning

confidence: 99%

The prevalence of neuropathic pain after non-traumatic spinal cord lesion

2006

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Study design: Retrospective register study. Objective: To investigate the predictive value of the following parameters for the development of neuropathic pain after non-traumatic spinal cord lesion: that is age at onset of spinal cord disease, gender, completeness of lesion, level of lesion, and aetiology. Setting: A unit for patients with post-acute traumatic and non-traumatic spinal cord lesions in the greater area of Stockholm, Sweden. Method: All patients with non-traumatic spinal cord lesions visiting the unit between 1995 and 2000 were classified according to the following: that is neuropathic pain at or below lesion level according to IASP criteria, age at time of the onset of the spinal cord symptoms, injury level, complete/incomplete injury, and aetiology. Results were analysed with w 2 -analysis and logistic regression. Results: In total, 38% had neuropathic pain, 15% had pain predominantly at the level of lesion, and 23% predominantly below the level of lesion. Of those with pain, 67% reported that the pain affected daily life. Women reported neuropathic pain below the level of lesion more often (40%) than men (13%). The prevalence was particularly high (64%) for patients with malignant spinal cord diseases. Neither age at onset of the spinal cord symptoms, nor complete/ incomplete injury nor injury level had significant influence on the prevalence. Conclusion: Neuropathic pain is common among patients with acquired non-traumatic spinal cord lesions regardless of aetiology, often causing severe problems in daily life.

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Spinal cord injury in Italy: A multicenter retrospective study

Cited by 92 publications

References 21 publications

Effects on age on spinal cord lesion patients' rehabilitation

Effects on age on spinal cord lesion patients' rehabilitation

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

The prevalence of neuropathic pain after non-traumatic spinal cord lesion

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