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EUROPEAN JOURNAL OF PHYSICAL AND REHABILITATION MEDICINE

A Journal on Physical Medicine and Rehabilitation after Pathological Events


Official Journal of the Italian Society of Physical and Rehabilitation Medicine (SIMFER), European Society of Physical and Rehabilitation Medicine (ESPRM), European Union of Medical Specialists - Physical and Rehabilitation Medicine Section (UEMS-PRM), Mediterranean Forum of Physical and Rehabilitation Medicine (MFPRM), Hellenic Society of Physical and Rehabilitation Medicine (EEFIAP)
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ORIGINAL ARTICLES  SPINAL CORD INJURIESFREEfree


Europa Medicophysica 2000 September;35(3):161-6

Copyright © 2000 EDIZIONI MINERVA MEDICA

language: English

Medical complications during the acute phase of traumatic spinal cord lesions

Aito S. 1, D’Andrea M. 1, Nardulli R. 2

1 Unità Spinale, Azienda Ospedaliera “Careggi”, Firenze, Italia; 2 Fondazione “S. Maugeri”, Cassano Murge (Bari), Italia


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BACKGROUND: The pre­ven­tion of com­pli­ca­tions dur­ing the ­acute ­phase of spi­nal ­cord inju­ries (SCIs) rep­re­sents the cor­ner­stone ­from ­which the mod­ern con­cept of SCI treat­ment orig­i­nat­ed, ­with Sir Ludwig Guttman and the Stoke Mandeville Spinal Unit in the UK. These com­pli­ca­tions can ­have a neg­a­tive ­impact on sur­vi­val, ­both in ­terms of neu­ro­log­i­cal recov­ery and func­tion­al re-edu­ca­tion.
METHODS: The aim of the ­present ­study was to ­assess the inci­dence of ­these com­pli­ca­tions and the pos­sible cor­re­la­tions ­between ­them and the ­type of ­care and reha­bil­i­ta­tion pro­vid­ed. The ­study pop­u­la­tion was ­drawn ­from the ­GISEM ­study (1997-1999), ­which ­involved the par­tic­i­pa­tion of 37 Rehabilitation Centres and Spinal Units, sit­u­at­ed main­ly in the north­ern and cen­tral of Italy. Only ­patients admit­ted with­in 60 ­days of trau­mat­ic inju­ry ­were con­sid­ered. This yield­ed a pop­u­la­tion of 588 ­patients (18% ­females and 82% ­males). Six of the ­most com­mon com­pli­ca­tions ­were con­sid­ered; name­ly, pres­sure ­sores, uri­nary com­pli­ca­tions, res­pir­a­to­ry com­pli­ca­tions, ­deep ­venous throm­bo­sis, pul­mo­nary embo­lism and par­a­os­te­oar­throp­a­thies.
RESULTS: Results ­revealed a ­high inci­dence of pres­sure ­sores (23,3%), ­while ­over ­half of the ­patients pre­sent­ed at ­least one of the com­pli­ca­tions ­under exam­ina­tion. Pressure ­sores ­occurred exclu­sive­ly ­among the ­patients ­whose admis­sion to the Spinal Units had ­been ­delayed or who had ­received ­initial treat­ment at non spe­cial­ised cen­tres.
CONCLUSIONS: From the anal­y­sis of the ­results, the ­authors con­clude ­that opti­mal reha­bil­i­ta­tion ­care, at ­least ­with ­regard to the pre­ven­tion of com­pli­ca­tions dur­ing the ­acute ­phase, ­entails ear­ly admis­sion to a spe­cial­ised mul­ti­dis­ci­pli­nary facil­ity; name­ly, a Spinal Unit.

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