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Nontraumatic spinal cord injury: demographic characteristics and complications
Peter W New1, H Barry Rawicki, Michael J Bailey
1Head Spinal Rehabilitation Unit, Caulfield General Medical Center Bayside Health, Melbourne, Australia. p.new@cgmc.org.au
Objectives:
To investigate the demographic characteristics and complications of nontraumatic spinal cord injury (NT/SCI), to compare patients who were admitted for initial rehabilitation with readmission rehabilitation patients, to compare our findings with those of other studies, and to develop a model to predict the length of stay (LOS).
Design:
Retrospective, 3-year, case series.
Setting:
Tertiary medical unit specializing in SCI rehabilitation in Australia.
Participants:
Consecutive sample of 134 adult referred inpatients with NT/SCI (58% women; median age, 61y). Patients requiring initial rehabilitation or readmission were included.
Intervention:
Chart review.
Main Outcomes Measures:
Demographic characteristics, neurologic injury, etiology, comorbidities, and complications of NT/SCI.
Results:
The most common cause of NT/SCI was tumor (20.1%), but there were many different etiologies. Tetraplegia occurred in 32.8% of patients, and 56% had motor incomplete injuries. Most patients (63%) had at least 1 complication, including urinary tract infection (32.8%), pressure ulcer (31.5%), and pain (18.7%). Initial rehabilitation patients were significantly older (initial median, 69y vs readmission median, 54y; P=.0001). A multivariate model for LOS was able to predict 52% of the variance.
Conclusions:
NT/SCI rehabilitation patients have a different demographic profile compared with traumatic SCI (T/SCI) patients and a lower prevalence of many of the complications that affect T/SCI patients. There are differences between initial and readmission patients.