Abstract
Celani MG, Spizzichino L, Ricci S, Zampolini M, Franceschini M, Retrospective Study
Group on SCI. Spinal cord injury in Italy: a multicenter retrospective study. Arch
Phys Med Rehabil 2001;82:589-96. Objective: To investigate certain factors influencing the length of stay (LOS) in a rehabilitation
center, the incidence of pressure ulcers, and the neurologic improvement of patients
with traumatic (T/SCI) and nontraumatic spinal cord injury (NT/SCI). Design: A multicenter retrospective study of patients with SCI admitted to rehabilitation
centers between 1 January 1989 and 31 December 1994 (only first admissions). Setting: Seven Italian rehabilitation centers. Patients: A total of 859 consecutively admitted adult patients with SCI. Intervention: Examined medical records of patients admitted to rehabilitation centers. Main Outcome Measures: Pressure ulcers on admission as an indicator of nursing care in acute phase, LOS
in rehabilitation centers, and neurologic improvement on discharge (using the Frankel
classification system). Other measures included level of lesion, associated lesions
(if T/SCI), surgical stabilization (if T/SCI), and time from the event to admission
to a rehabilitation center. Results: In all cases, the time from event to admission to a rehabilitation center exceeded
30 days (average ± standard deviation: T/SCI, 54.6 ± 43.7d; NT/SCI, 166.9 ± 574d);
pressure ulcers on admission were present in 34.1% of T/SCI and 17.1% of NT/SCI patients.
The average LOS in a rehabilitation center was 143.1 ± 89.1 days for T/SCI and 91.7
± 78.9 days for NT/SCI; Frankel grades improved by 1 or more in 34.4% of T/SCI and
34.1% of NT/SCI patients. The presence of pressure ulcers on admission, rehabilitation
LOS, and neurologic improvement on discharge correlated highly with severe neurologic
damage on admission in both T/SCI and NT/SCI patients as well as with management of
the patient immediately before admission to a rehabilitation center, mainly in NT/SCI
patients. Conclusions: Severe neurologic damage is the major determining factor in predicting neurologic
recovery. Pressure ulcer prevention is statistically associated with neurologic improvement
and the shortening of rehabilitation LOS. Patient management immediately before admission
to rehabilitation has a statistical correlation with neurologic improvement in all
patients studied and on both rehabilitation LOS and incidence of pressure ulcers in
the NT/SCI patients. © 2001 by the American Congress of Rehabilitation Medicine and the American Academy
of Physical Medicine and Rehabilitation
Keywords
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Article Info
Publication History
Accepted:
July 5,
2000
Footnotes
☆Supported in part by regional health service public funds.
☆☆No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the author(s) or on any organization with which the author(s) is/are associated.
★Reprint requests to M. Grazia Celani, MD, Servizio per le Malattie Cerebrovascolari, Dipartimento di Medicina A.USL 2 dell'Umbria, Ospedale Città della Pieve, Via Beato Giacomo Villa, Città della Pieve 06062 Perugia, Italy, e-mail: [email protected] .
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© 2001 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.
