Traumatic vs non-traumatic spinal cord lesions: comparison of neurological and functional outcome after in-patient rehabilitation

Gupta, Anupam; Taly, Arun B.; Srivastava, Abhishek; Vishal, S. B.; Murali, T

doi:10.1038/sj.sc.3102168

Cited by 42 publications

(44 citation statements)

References 21 publications

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“…Consistent with other studies, 7,18,19 NTSCI patients had significantly fewer days spent in inpatient rehabilitation compared to TSCI and had higher FIM scores upon discharge. Both NTSCI and TSCI had high outpatient health care utilization patterns; however, there were differences in the types of health care used.…”

Section: Discussionsupporting

confidence: 89%

“…Other studies have reported mean ages for NTSCI ranging from 31 to 61 years with a relatively even sex distribution. 3,18,19 The majority of the NTSCI sample had paraplegia compared with the TSCI group which is also consistent with previous work. 6,7 It is noteworthy that 42% of the NTSCI sample did not have a level of injury specified whereas only 14.3% were nonspecified for TSCI.…”

Section: Socio-demographic and Clinical Characteristicssupporting

confidence: 90%

“…6,7,18,19 In particular, our NTSCI sample had a mean age of 61.6 years with 52.2% of the sample being male patients. Other studies have reported mean ages for NTSCI ranging from 31 to 61 years with a relatively even sex distribution.…”

Section: Socio-demographic and Clinical Characteristicsmentioning

confidence: 98%

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Health care utilization in non-traumatic and traumatic spinal cord injury: a population-based study

et al. 2009

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Study Design: Retrospective cohort design. Objectives: To compare socio-demographic, impairment characteristics and utilization (physician and emergency department (ED) visits) for non-traumatic (NTSCI) and traumatic (TSCI) spinal cord injury 1 year post inpatient rehabilitation. Setting: Ontario, Canada. Methods: Inpatient stays (2003)(2004)(2005)(2006) were identified from the National Rehabilitation Registry System. Exclusions were: in-hospital mortality; discharge after 31 March 2006; death within 1 year after discharge. Multivariate logistic regression analyses were used to determine factors predicting high utilization. Results: NTSCI cases (n ¼ 1002) were greater than TSCI (n ¼ 560). NTSCIs were older (mean ¼ 61.6, s.d. ¼ 15.8) with more co-morbidities, paraplegic (39.5%) and female (Po0.001). NTSCI had higher FIM admission and discharge scores but lower change scores. Mean number of physician visits for NTSCI and TSCI were 31.2 (median ¼ 24) and 29.7 (median ¼ 22), with no significant differences in mean specialist visits (NTSCI 16.5: TSCI 17.0). Factors predicting 30 or more physician visits included age 60 years or above (OR ¼ 1.5; 95% CI ¼ 1.2-1.9), urban living (OR ¼ 1.59; 95% CI ¼ 1.12-2.22) and lowest quartile (18-88) discharge FIM (OR ¼ 1.8; 95% CI ¼ 1.4-2.3). Charlson score of 3 or more (OR ¼ 2.1; 95% CI ¼ 1.3-3.2), urban living (OR ¼ 1.92; 95% CI ¼ 1.3-2.86) and lowest quartile discharge FIM (OR ¼ 1.5; 95% CI ¼ 1.2-2.0) were associated with 20 or more specialist visits. Factors for high ED use were: rurality (OR ¼ 1.5; 95% CI ¼ 1.1-2.1), low income (OR ¼ 1.4; 95% CI ¼ 1.1-1.9) and low (18-88) discharge FIM (OR ¼ 1.7; 95% CI ¼ 1.3-2.2). Conclusion: Both demonstrated significant health care utilization requiring attention to health care needs; particularly for those living in rural settings, with low income and/or low functional ability.

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Section: Discussionsupporting

confidence: 89%

Section: Socio-demographic and Clinical Characteristicssupporting

confidence: 90%

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Health care utilization in non-traumatic and traumatic spinal cord injury: a population-based study

et al. 2009

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“…McKinley et al attributed this difference to the fact that non-traumatic patients were more often motor incomplete (ASIA C and D) than their traumatic counterparts. Similar results have been reported by Ones et al, 9 while Gupta et al 10 did not find any difference between the two populations at admission. Unfortunately in both these studies a correction for the covariant effect of age and neurological impairment is lacking, so their results are difficult to interpret.…”

Section: Discussionsupporting

confidence: 88%

“…However, in spite of the high incidence of non-traumatic lesions, which is considered to vary between 25 and 80% of the total admission for spinal cord injuries, there are still few studies on the influence of different etiologies (namely traumatic vs non-traumatic) on SCL outcome; [5][6][7][8][9][10][11] this is probably due to the different features of the two populations with regard to age, lesion severity and lesion to admission time (LTA), which are wellknown prognostic factors: 5 therefore, the two groups of patients are poorly comparable.…”

Section: Introductionmentioning

confidence: 99%

Traumatic and non-traumatic spinal cord lesions: an Italian comparison of neurological and functional outcomes

et al. 2010

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Study design: Retrospective study. Objective: To compare the rehabilitation outcomes of non-traumatic and traumatic spinal cord injury patients. Setting: Spinal cord unit of a rehabilitation hospital in Italy. Patients and methods: In total, 380 patients at first rehabilitation stay after the lesion (144 traumatic patients and 236 non-traumatic patients; 244 men and 136 women; mean age 46.1±19.9 years; mean lesion to admission time 49.6 ± 39.8 days). Interventions: Not applicable. Measures: American Spinal Injury Association standards; Barthel index (BI), Rivermead mobility index and walking index for spinal cord injury. Statistical analysis: Poisson regression models with relative risks and 95% confidence intervals adjusted for the following confounders: age, sex, lesion level and Asia impairment. Models were stratified by age because a strong interaction between different variables and age was found. Results: Traumatic and non-traumatic populations showed several significant differences with regard to age, level and severity of lesion. When adjusted for these factors patients with traumatic injuries showed a significantly lower BI score at admission and significantly better improvement in the BI score by discharge. The two populations were discharged with similar functional outcome. No significant differences were found with regard to the others outcomes. Conclusions:In clinically stable patients, spinal cord injury etiology does not seem to affect the rehabilitative prognosis. At admission, traumatic patients show lower autonomy in daily life activities, probably because of the associated lesions that these patients often have. At discharge, traumatic and non-traumatic spinal cord lesion patients achieved similar results with regard to neurological and functional improvement.

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Spinal Cord Injury

Dixon

Budd

2016

Practical Psychology in Medical Rehabilitation

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Traumatic vs non-traumatic spinal cord lesions: comparison of neurological and functional outcome after in-patient rehabilitation

Cited by 42 publications

References 21 publications

Health care utilization in non-traumatic and traumatic spinal cord injury: a population-based study

Health care utilization in non-traumatic and traumatic spinal cord injury: a population-based study

Traumatic and non-traumatic spinal cord lesions: an Italian comparison of neurological and functional outcomes

Spinal Cord Injury

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