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  4. The Primary and Secondary Causes of Hospitalizations During the First Five Years After Spinal Cord Injury

The Primary and Secondary Causes of Hospitalizations During the First Five Years After Spinal Cord Injury

Spinal Cord, 2022 · DOI: 10.1038/s41393-022-00750-9 · Published: June 1, 2022

Spinal Cord InjuryHealthcareRehabilitation

Simple Explanation

This study looks at why people with spinal cord injuries (SCI) are hospitalized in the first five years after their injury. It distinguishes between emergency department (ED) visits and planned inpatient (IP) admissions to understand the different health issues leading to hospitalization. The researchers analyzed data from a population-based registry and billing data to identify the most common primary and secondary diagnoses associated with hospital admissions. The findings highlight the importance of targeted prevention strategies, patient education, and early access to primary care to reduce hospitalizations for preventable conditions in people with SCI.

Study Duration
5 Years
Participants
2569 adults with traumatic SCI
Evidence Level
Cohort study. Retrospective analysis

Key Findings

  • 1
    In the first year after SCI, rehabilitation, septicemia, and chronic skin ulcers were the most frequent primary diagnoses for hospital admissions.
  • 2
    Septicemia, urinary tract infections, and pneumonia were the leading causes of ED admissions, while rehabilitation and chronic ulcers of the skin were the leading causes of IP admissions.
  • 3
    In years 2–5, septicemia and complications related to certain procedures (like urinary catheters) were more frequent in ED admissions, while chronic skin ulcers and rehabilitation were more common in IP admissions.

Research Summary

This study examined the primary and secondary causes of hospitalizations in the first five years after spinal cord injury (SCI), differentiating between emergency department (ED) and inpatient (IP) admissions. The results showed that the leading causes of hospitalization varied by year post-injury and admission type. Rehabilitation diagnoses were more prominent in the first year, while septicemia and chronic skin ulcers were leading causes for ED and IP admissions, respectively. The authors conclude that targeted prevention strategies, patient education, and early access to primary care are crucial for reducing hospitalizations for preventable conditions in individuals with SCI.

Practical Implications

Targeted Prevention Strategies

Develop and implement prevention strategies focused on common causes of hospitalization, such as septicemia, urinary tract infections, and pressure ulcers.

Enhanced Patient/Caregiver Education

Improve patient and caregiver education regarding the management and prevention of secondary health conditions to reduce ED visits.

Improved Access to Primary Care

Ensure early and appropriate access to primary care services to manage chronic conditions and prevent acute complications requiring hospitalization.

Study Limitations

  • 1
    Retrospective analysis of UB-04 discharge data, not individual clinical data.
  • 2
    Data only included non-federal hospitals in South Carolina.
  • 3
    Reported diagnoses may be influenced by payer reimbursement policies.

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