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Age and serum albumin are risk factors for 30-day mortality after PEG. Patients with dementia or SCI do not have a significantly shorter survival after PEG than patients with intact cognitive function.

While the overall bolus transit is impaired in both patients with achalasia and scleroderma regional pressure and bolus transit differences exist. Bolus transit abnormalities result from abnormal esophageal body contraction and not abnormal LES relaxation.

Background To describe the key findings and lessons learned from an international pilot study that surveyed spinal cord injury programs in acute and rehabilitation facilities to understand the status of spinal cord injury care. Methods An online survey with two questionnaires, a 74-item for acute care and a 51-item for rehabilitation, was used. A subset of survey items relevant to the themes of specialized care, timeliness, patient-centeredness, and evidence-based care were operationalized as structure or process indicators. Percentages of facilities reporting the structure or process to be present, and percentages of indicators met by each facility were calculated and reported separately for facilities from high-income countries (HIC) and from low and middle-income countries (LMIC) to identify “hard to meet” indicators defined as those met by less than two-thirds of facilities and to describe performance level. Results A total of 26 acute and 26 rehabilitation facilities from 25 countries participated in the study. The comparison of the facilities based on the country income level revealed three general observations: 1) some indicators were met equally well by both HIC and LMIC, such as 24-hour access to CT scanners in acute care and out-patient services at rehabilitation facilities; 2) some indicators were hard to meet for LMIC but not for HIC, such as having a multidisciplinary team for both acute and rehabilitation settings; and 3) some indicators were hard to meet by both HIC and LMIC, including having peer counselling programs. Variability was also observed for the same indicator between acute and rehabilitation facilities, and a wide range in the total number of indicators met among HIC facilities (acute 59–100%; rehabilitation 36–100%) and among LMIC facilities (acute: 41–82%; rehabilitation: 36–93%) was reported. Conclusions Results from this international pilot study found that the participating acute and rehabilitation facilities on average adhered to 74% of the selected indicators, suggesting that the structure and processes to provide ideal traumatic spinal cord injury care were broadly available. Recruiting a representative sample of SCI facilities and incorporating regional attributes in future surveys will be helpful to examine factors affecting adherence to indicators.

This event is an accredited group learning activity as defined by the Maintenance of Certification Program of the Royal College of Physicians and Surgeons of Canada. The Annual Scientific Conference of the Canadian Spine Society provides a yearly review of spine care in Canada. This year the first combined conference widens its perspective to encompass participation by both the Spine Society of Australia and the New Zealand Orthopaedic Spine Society. There is also an increased contribution from paediatric spine. In addition to a review of surgical advances, the agenda covers a range of non-operative innovations and epidemiological studies. Presentations by members of the three societies will highlight the similarities, differences and common problems in three separate health care systems. Of particular interest are the management of neuromuscular spinal deformity and motion preserving surgery for degenerative back pain. A special focus is the development of national spine registries. Parallel efforts in all three countries will be compared and the conference will consider the possibility of international cooperation.