Rehabilitation outcomes following traumatic spinal cord injury in a tertiary spinal cord injury centre: a comparison with an international standard

Abstract

Study design: Retrospective descriptive analysis of data of patients with traumatic spinal cord injury (SCI) in a tertiary SCI centre. Objectives: To identify the characteristics of the rehabilitation outcomes of patients with different levels of traumatic SCI and to compare the results with data reported in the American Consortium for Spinal Cord Medicine. Setting: A newly established tertiary SCI centre in Tai Po Hospital, Tai Po, Hong Kong. Methods: A total of 33 patients with traumatic SCI admitted in 2002 were included in the study. They were classified into different ASIA subgroups based on their levels and completeness of injury. The functional status changes measured by the Functional Independence Measure (FIM)t (on admission, placement and upon discharge, and at 1 and 3 months post discharge) and discharge placement were recorded as rehabilitation outcomes. Results: A total, 24 patients were tetraplegic while nine were paraplegic. Seven and two from tetraplegic and paraplegic groups were readmitted with late complications due to urinary tract infection, spasticity and/or occurrence of pressure sores. The mean age was found to be 48.36 (SD ¼ 15.64) years. In all, 16 (48.48%) sustained the injury from falling from height. The trend of FIM motor scores at discharge across different ASIA subgroups appeared to be comparable to those reported in the American Consortium for Spinal Cord Medicine with scores generally lower. Significant functional improvements during the hospital phase were found in the two tetraplegic and paraplegic ASIA D subgroups (t(3) ¼ 3.430, Po0.05; t(2) ¼ 4.083, P ¼ 0.55, respectively). Significant differences were also revealed among subgroups (F(7,32) ¼ 6.625, Po0.0005) with lower level tetraplegic groups appearing to stay much longer in the rehabilitation centre. In all, 64.5% of newly diagnosed patients returned to live in the community. Conclusions: This report gives a preliminary overview on the characteristics of rehabilitation outcomes in one of the SCI centres in Hong Kong in relation to the international standard. Longitudinal study with larger population and community integration outcomes might be included in the future to reveal a better picture in the SCI rehabilitation in Hong Kong.Spinal Cord (2005) 43, 489-498.

Properties and outcomes of spinal rehabilitation units in four countries

“…10 This is supported by the relative reduction in SCIM at discharge and the relatively low SCIM gain in Denmark, after controlling for admission SCI-ARMI. But other factors can also contribute to the outcome differences, including the higher (although statistically hardly significant) proportion of tetraplegia patients [13][14][15] and a ceiling effect of the frequent AIS D lesions 16,17 in the Danish unit, which in part may be unrelated to TAR. A daily task implementation assessment that is more sensitive to changes in higher functions, such as rapid walking, may have increased performance gain in Denmark.…”

A comparative review of life satisfaction, quality of life and mood between Chinese and British people with tetraplegia

“…Overall Functional independence measure motor scores for people with SCI in Hong Kong are significantly lower than people with SCI in America. 10 Similarly, a higher mortality rate is found for people with SCI in the first year post-injury in countries with a developing economy, for example Zimbabwe 11 compared to America. 12 Although one contributing factor to this may be differing injury characteristics across countries, Deconinck 6 proposed that the weaker health care system present in countries with developing economies accounts for a lot.…”

Parameters for positive outcome of the in-hospital rehabilitation of spinal cord lesion patients: the Boberg Quality Score

“…Next to the determination of the functional status analyses of socio-demographic data are often highlighted. 2,1,[3][4][5][6][7] Other studies focus on the importance of related symptoms such as pain, psychosocial problems and loss of energy in the rehabilitation patient or the compliance of the patient is seen as a main outcome factor. [8][9][10][11][12][13][14][15][16][17] Studies researching the social reintegration mainly focus on occupational situation, living conditions and quality of life.…”