Complications During the Inpatient Rehabilitation Period in Neurological Subjects

Abstract

Objective To explore common complications in people with neurological conditions during rehabilitation admission. Methods: All neurological subjects, including those with stroke, spinal cord injury (SCI), and traumatic brain injury, who were admitted for intensive and less-intensive rehabilitation programs during January to December 2012 were recruited. Both avoidable and unavoidable complications and related factors were assessed. Results: Among 1146 subjects, 65% was male with a mean age of 54.5 years. Almost 90% were admitted for intensive rehabilitation. The common avoidable complications that occurred were urinary tract infection (UTI) (12.8%), musculoskeletal pain (7.0%), neuropathic pain (2.3%), pneumonia (1.5%), and pressure injury (1.2%). Spasticity, which is an unavoidable complication, occurred in 2.1% of subjects. Older age, male gender, diagnosis of SCI, and longer stay were important factors related to complications. Conclusions: Most of the common complications during rehabilitation were avoidable complications, especially UTI and pain. A heightened level of awareness and vigilance should be exercised in older male subjects, those with prolonged hospital stay, and those with a diagnosis of SCI.

The Relevance of Differential Assessment Between Campimetry Deficit and Neglect in Hospitalized Neurologic Patients

“…7 Stroke itself can present with various visual problems including gaze palsies, visual field defects, diplopia, reduced vision, ptosis, pupillary and eye movement disorders, and cortical blindness. 8,9 Visual neglect represents a common deficit in patients following stroke, and its differentiation from campimetry defects is not always easy, particularly as the 2 conditions may coexist. 10,11 Indeed, screening sensory vision and visual perceptual deficits in stroke survivors is primarily carried out by specialized orthoptist, 12 in order to carry out a proper differential diagnosis between coexisting ocular disease and preexisting low vision, as well as visual neglect, frequently diagnosed as a deficit of visual perception following stroke, though it is defined by neuropsychologist as an attentional processing deficit.…”

“…After stroke, ocular and visual impairments may occur as a relevant issue in just about every facet of stroke medicine, representing the primary neurologic symptom in 20.5% of patients with stroke 7. Stroke itself can present with various visual problems including gaze palsies, visual field defects, diplopia, reduced vision, ptosis, pupillary and eye movement disorders, and cortical blindness 8,9…”