The impact of acute management on the occurrence of medical complications during the specialized spinal cord injury acute hospitalization following motor-complete cervical spinal cord injury

The Journal of Spinal Cord Medicine, 2018 · DOI: 10.1080/10790268.2017.1350331 · Published: January 1, 2018

Spinal Cord Injury Trauma Rehabilitation

Simple Explanation

This study examines how early and complete care in a specialized spinal cord injury center affects medical complications after tetraplegia. The study compares patients promptly managed in a specialized center to those initially managed in a non-specialized center before transfer. The findings suggest similar complication rates between the two groups, but longer hospital stays for those initially managed in non-specialized centers.

Study Duration

April 2008 and November 2014

Participants

116 individuals with acute traumatic motor-complete cervical SCI

Evidence Level

Level 1, Retrospective comparative cohort study

Key Findings

1
The rate of medical complications during the SCI-center stay was similar for individuals early and lately managed in the SCI-center.
2
Individuals transferred to the SCI-center after spinal surgery, were hospitalized significantly longer in acute care.
3
High cervical injuries (C1-C4) showed an important tendency to increase the likelihood of developing a complication.

Research Summary

This study assesses the occurrence of complications during the acute hospitalization phase with respect to the timing of admission of the SCI-center following a motor-complete cervical SCI. Results of this study indicate that the rate of medical complications during the SCI-center stay was similar for individuals early and lately managed in the SCI-center Prompt transfer to a SCI-center before surgery for motor-complete cervical SCI may optimize the care trajectory by favouring earlier transfer to rehabilitation.

Practical Implications

Optimize Care Trajectory

Prompt transfer to a specialized SCI center may facilitate earlier transfer to rehabilitation.

Resource Allocation

Perioperative management in non-specialized centers may require higher hospital resource utilization.

Risk Stratification

High cervical injuries are associated with a greater likelihood of developing complications.

Study Limitations

1
Small number of patients, particularly for Group 2, limiting the statistical power of this study.
2
Patient management may vary in the different centers, which may have influenced our results and limit the external validity of this study.
3
Data pertaining to the surgical intervention was not collected in this study.

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