M Tan1, P W New. 1. Registrar, Spinal Rehabilitation Unit, Caulfield Hospital, Alfred Health, Caulfield, Victoria, Australia. michael.tan@svhm.org.au
Abstract
STUDY DESIGN: Retrospective study. OBJECTIVES: To examine the rehabilitation outcomes for patients with spinal cord injury (SCI) due to tumour, with a focus on the impact of pain on disability and length of stay (LOS). SETTING: Public hospital inpatient spinal rehabilitation unit, Melbourne, Australia. METHODS: Retrospective open-cohort case series of consecutive patients admitted between 1/7/1996 and 30/6/2008 with a diagnosis of recent onset tumour causing SCI. RESULTS: In all 108 patients were admitted, of whom 62% (n=67) were male. The median age was 61.5 years (interquartile range (IQR) 53.6-74). Most patients had paraplegia (n=97, 89.8%) and a metastatic tumour (n=71, 65.7%) causing their SCI. For patients with a primary tumour the Rasch motor functional independence measure (FIM) gain between admission and discharge (median 17, IQR 4-23) was significantly greater (P=0.006) than for those with secondary tumour (median 7, IQR from -4 to 15). Pain was present in 52% of patients and had a significant adverse influence on the rehabilitation process, with FIM motor efficiencies of 0.09 in patients with documented pain compared with 0.39 in patients without pain (P=0.01). Patients with pain had significantly prolonged median LOS of 56 days (IQR 32.5-84.5) compared with 42 days (IQR 20.5-72.5, P=0.03) without pain. CONCLUSION: Patients with SCI due to tumour have the potential to benefit from a focused, specialised SCI rehabilitation programme to optimise their outcomes. Careful patient selection, modifying the focus of team goals and a close relationship with treating oncologists and palliative care teams is essential.
STUDY DESIGN: Retrospective study. OBJECTIVES: To examine the rehabilitation outcomes for patients with spinal cord injury (SCI) due to tumour, with a focus on the impact of pain on disability and length of stay (LOS). SETTING: Public hospital inpatient spinal rehabilitation unit, Melbourne, Australia. METHODS: Retrospective open-cohort case series of consecutive patients admitted between 1/7/1996 and 30/6/2008 with a diagnosis of recent onset tumour causing SCI. RESULTS: In all 108 patients were admitted, of whom 62% (n=67) were male. The median age was 61.5 years (interquartile range (IQR) 53.6-74). Most patients had paraplegia (n=97, 89.8%) and a metastatic tumour (n=71, 65.7%) causing their SCI. For patients with a primary tumour the Rasch motor functional independence measure (FIM) gain between admission and discharge (median 17, IQR 4-23) was significantly greater (P=0.006) than for those with secondary tumour (median 7, IQR from -4 to 15). Pain was present in 52% of patients and had a significant adverse influence on the rehabilitation process, with FIM motor efficiencies of 0.09 in patients with documented pain compared with 0.39 in patients without pain (P=0.01). Patients with pain had significantly prolonged median LOS of 56 days (IQR 32.5-84.5) compared with 42 days (IQR 20.5-72.5, P=0.03) without pain. CONCLUSION:Patients with SCI due to tumour have the potential to benefit from a focused, specialised SCI rehabilitation programme to optimise their outcomes. Careful patient selection, modifying the focus of team goals and a close relationship with treating oncologists and palliative care teams is essential.
Authors: Danielle Zacaron Santos; Isabel Cristina Gonçalves Leite; Maximiliano Ribeiro Guerra Journal: Support Care Cancer Date: 2018-04-06 Impact factor: 3.603
Authors: Peter Wayne New; Inge Eriks-Hoogland; Giorgio Scivoletto; Ronald K Reeves; Andrea Townson; Ruth Marshall; Farooq A Rathore Journal: Top Spinal Cord Inj Rehabil Date: 2017
Authors: Maayken Elizabeth Louise van den Berg; Juan M Castellote; Jose Ignacio Mayordomo; Ignacio Mahillo-Fernandez; Jesus de Pedro-Cuesta Journal: Biomed Res Int Date: 2017-07-25 Impact factor: 3.411