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ORIGINAL ARTICLES  SPINAL CORD INJURIES Free accessfree

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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