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Complications of Spinal Cord Injury Over the First Year After Discharge From Inpatient Rehabilitation

Published:January 20, 2017DOI:https://doi.org/10.1016/j.apmr.2016.12.011

      Abstract

      Objectives

      To describe the prevalence and cumulative incidence of secondary complications of spinal cord injury (SCI) in the first year after discharge from inpatient rehabilitation (IR); and to evaluate potential associations between risk of complications and sociodemographic and injury-specific factors.

      Design

      Secondary analysis of data collected for a single-site, single-blind, randomized controlled trial comparing telephone follow-up with usual care.

      Setting

      Inpatient rehabilitation units.

      Participants

      Adults ages ≥18 years (N=169) within 1 year of discharge from IR after SCI.

      Interventions

      Not applicable.

      Main Outcome Measures

      Self-report of 10 secondary complications of SCI.

      Results

      Participants experienced a mean of 4.7 complications over 12 months. The most frequently reported complications were urinary tract infection (UTI), autonomic dysreflexia (AD), and pressure ulcers, with cumulative incidences of 62%, 43%, and 41%, respectively. Bone and soft tissue injuries (cumulative incidence, 35%) and bowel problems, including impaction or severe constipation (cumulative incidence, 33%), were also common. Cumulative incidences of AD, decubitus ulcers, UTI, and problems with bladder were greater in participants with higher level and more complete injuries, and some recurrent complications were common. Age at injury and impairment level significantly affected rates of complications, and subjects developed an average of 2.33 distinct complications during the study period.

      Conclusions

      People with SCI are at high risk for a number of secondary complications over the first year after discharge from IR. Although these data offer some insight into who with SCI is at highest risk for first time and recurrent complications, further study is needed to refine this understanding and to develop effective educational and prevention strategies.

      Keywords

      List of abbreviations:

      AD (autonomic dysreflexia), AIS (American Spinal Injury Association Impairment Scale), IR (inpatient rehabilitation), LOS (length of stay), SCI (spinal cord injury), UTI (urinary tract infection)
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