Spinal cord injuries in Arkansas due to violence: 1980 – 1989

Carroll, Constance M.

doi:10.1038/sj.sc.3100368

Cited by 12 publications

(2 citation statements)

References 3 publications

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“…The difference in the two groups concerning age and gender ratio are similar to those reported in the literature, 12,8 while concerning the aetiology it reflects the social context with similar causes for traumatic SCL as for other Western countries apart from violence. 7,13 The NT group, although with possible selection bias from the recruitment sources, also shows similar aetiologies to those found in other papers. 10,8,7 The prevalence of cervical lesions (34%) is in the lower bracket of the range of findings reported in the literature (38-51%) 14,11,9 with a higher probability OR=odds ratio, CI=confidence interval 95%; NK=not known; DVT=deep venous thrombosis of risk for cervical injury being of T than NT aetiology, as already reported.…”

Section: Discussionsupporting

confidence: 77%

Spinal cord lesion management in Italy: a 2-year survey

et al. 2003

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Objectives: To compare the route from injury to rehabilitation, and the outcome of care in a large sample of traumatic (T) and nontraumatic (NT) spinal cord lesion (SCL) patients at their 'first admission'. Setting: T and NT SCI patients consecutively admitted to 37 SCL centres in Italy. Method: Data were recorded on simple, computerised, closed-question forms, which were Centrally collected and analysed. Descriptive and inferential analysis was conducted to define the characteristics and compare the T and NT populations, and to identify correlations among the variables examined: time from the event to admission (TEA); pressure sores (PS) on admission; length of stay (LoS) and destination on discharge. Results: A total of 1014 SCL patients, 67.5% with a lesion of T and 32.5% of NT aetiology were analysed. The subjects in the T group were younger (median 34 versus 58 years), with higher probability of cervical involvement (OR 2.47, CI 1.8-3.4) and completeness of the lesion (OR 3.0, CI 2.3-4.0), shorter median TEA(37 versus 64 days, Po0.0001) and less frequent admission from home (3.6 versus 17.4%) compared to the NT group. TEA and PS on admission were analysed as indicators of the efficacy of the courses from injury to rehabilitation. Longer TEA was reported for people with NT aetiology, admitted to rehabilitation centre (RC), not locally resident, transferred from certain wards and to a lesser degree female subjects and those with complications on admission. PS were associated to www.nature.com/sc completeness of lesion, longer TEA, admission to RC, nonlocal residence and coming from general intensive care units, or general surgery wards. Median LoS was 99 days (mean 116 and range 0-672), and was statistically shorter in the NT group (122 versus 57 median, Po0.00001). Upon discharge, bladder and bowel autonomy were, respectively, obtained in 68.1 and 64.5% of the whole population without significant difference between the T and NT groups. A total of 80.2% of patients were discharged home and the following factors: not living alone, being discharged after longer LoS, having sphincterial autonomy and no PS, were all independent predictors of outcome. Conclusion: There are important obstacles in the admission route to rehabilitation facilities, greater for NT, as longer TEA and more complications on admission testify. Moreover, the LoS is shorter for NT population. Our findings suggest that rehabilitation outcome could be improved through an early multidisciplinary approach and better continuity between acute and rehabilitation care, especially for the 'neglected' NT SCL patients.

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