The Tetrafigap Survey on the long-term outcome of tetraplegic spinal cord injured persons: Part III. Medical complications and associated factors

Abstract

Study design: To study the short-and long-term medical complications encountered in tetraplegic spinal cord injured persons (TSCI) and to give prominence to both the medical and socio-economic factors with which they are respectively associated. Methods: The Tetra®gap Study is a multicentre epidemiological survey carried out using selfadministered questionniares studying the global long-term outcome of TSCI patients after the initial phase of rehabilitation. Results: The data for 1668 patients were analyzed. The rate of rehospitalisations was 74.4% with on average three stays per patient and as reported causes, in descending order: urinary complications, systematic follow-up, pressure sores, respiratory complications, contractures, bowel complications, pains and secondary fractures of the lower limbs. At the time of the survey, 84.7% of patients mentioned awkward contractures, 73.8% pains, 55.9% embarrassing urinary leakage and 14.1% pressure sores. With regard to persons su ering from complete motor lesion, urinary complications and pressure sores were more frequently reported, whereas for persons su ering from incomplete motor lesions, awkward contractures and pains were more frequent. In the elderly, pains were more often mentioned, and pressure sores and pain were also the most common in patients coming from lower socio-professional status. Contractures and pain decreased with time. All these complications but pressure sores and pain are statistically interrelated. Conclusion: The medical complications of spinal cord injured persons are frequent, they are linked to biological, psychological and environmental factors, and are interrelated. Therefore, seeking mid-and long-term risk factors must be given priority in order to better adapt attempts at increasing secondary prevention.

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

“…The Tetrafigap survey of patients with tetraplegia reported contractures in 84.7% of respondents. 20 In the present study, at least one contracture was observed in 17.3% of subjects with NTSCL. The contractures interfere with performance of motor tasks, contribute to spasticity and result in deformity.…”

“…Similarly, 36.5% of subjects in Tetrafigap study also had this complication. 20 In the present study 31% of subjects with NTSCL had constipation. This could be due to immobility, changes in colonic compliance, prolonged transit time, fecal impaction, poor fluid intake and low fiber content in diet.…”

Pain after paraplegia: a survey in India

“…7,12,13 The reason could be the decrease in plasticity of the central nervous system with age, as far as neurogenic pain is concerned, as well as overuse of supra-lesional joints leading to osteo-articular pains. 14 Another factor could be psycho-social stresses. 10 Pain in the back and chest was seen in all the groups especially in the group that were 1-o6 months after injury.…”

Remote monitoring of sitting behaviors for community-dwelling manual wheelchair users with spinal cord injury

“…[1][2][3] The reported prevalence of pressure ulcers among spinal cord-injured manual wheelchair users (MWUs) ranges from 14 to 85%, and the most common site is the ischial tuberosity. [4][5][6] In sitting, the study showed that 18% of the body weight is distributed over each ischial tuberosity region. 7 Able-bodied people are able to sense physical discomforts associated with prolonged sitting and are able to reposition their body positions frequently, thereby protecting their tissues from ischemic damage.…”