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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 , , , ,
In association with
Indexed/Abstracted in: CINAHL, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 2,063
ORIGINAL ARTICLES SPINAL CORD INJURIES
Europa Medicophysica 2000 September;35(3):161-6
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
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.