Abstract:
STUDY DESIGN:Prospective, population-based cohort study. OBJECTIVES:To determine the prevalence of selected complications following traumatic spinal cord injury during acute care and to identify the risk factors for pressure ulcers. SETTING:The only tertiary academic (Groote Schuur) hospital in the catchment region providing specialised acute care. METHODS:A descriptive, observational study of an inception cohort. Secondary complications were predefined and consisted of pressure ulcers, pulmonary complications (pneumonia and atelectasis), urinary tract infections, autonomic dysreflexia, deep vein thrombosis, pulmonary embolism, postural hypotension, neuropathic pain and spasticity. Possible risk factors for pressure ulcers included variables concerning demographic and injury characteristics and complications. Both univariate and multivariate logistic regression analyses were used. RESULTS:Data of 141 patients (97%) were analysed. In total, 71 (50.3%) patients had one or more complication. The most common was pressure ulcers (n=42; 29.8%), followed by pulmonary complications (n=33; 23.4%) and urinary tract infections (n=24; 17%). Significant risk factors were gun-shot injury, motor completeness (American Spinal Injury Association Impairment Scale (AIS) A│B), vertebral injury, no spinal surgery, pulmonary complications, urinary tract infection and level of consciousness. In the final multivariate model that correctly predicted 81.6% of subjects, motor completeness and vertebral injury remained significant independent factors, whereas having a urinary tract infection was associated with an increased risk (odds ratio: 2.86), but not significant at the 5% level. CONCLUSION:Pressure ulcers and pulmonary complications were prevalent during specialised acute phase. The occurrence of pressure ulcers, despite protocols in place, is worrisome. To prevent pressure ulcers, special attention seems necessary for persons with motor complete lesions and those with vertebral injuries.
journal_name
Spinal Cordjournal_title
Spinal cordauthors
Joseph C,Nilsson Wikmar Ldoi
10.1038/sc.2015.189subject
Has Abstractpub_date
2016-07-01 00:00:00pages
535-9issue
7eissn
1362-4393issn
1476-5624pii
sc2015189journal_volume
54pub_type
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