CONTEXT/ OBJECTIVE: Determine the impact of early admission and complete perioperative management in a specialized spinal cord injury (SCI) trauma center (SCI-center) on the occurrence of medical complications following tetraplegia. DESIGN: A retrospective comparative cohort study of prospectively collected data involving 116 individuals was conducted. Group 1 (N=87) was early managed in a SCI-center promptly after the trauma, whereas Group 2 (N=29) was surgically and preoperatively managed in a non-specialized (NS) center before being transferred to the SCI-center. Bivariate comparisons and multivariate logistic regression analyses were used to assess the relationship between the type of acute care facility and the occurrence of medical complications. Length of stay (LOS) in acute care was also compared. SETTING: Single Level-1 trauma center. PARTICIPANTS: Individuals with acute traumatic motor-complete cervical SCI. INTERVENTIONS: Not applicable Outcome measures: The occurrence of complications during the SCI-center stay. RESULTS: There was a similar rate of complications between the two groups. However, the LOS was greater in Group 2 (p=0.04). High cervical injuries (C1-C4) showed an important tendency to increase the likelihood of developing a complication, while high cervical injuries and increased trauma severity increased the odds of developing respiratory complications. CONCLUSION: Although complication rates were similar in non-specialized and specialized centers, peri-operative management in a non-specialized center required a longer length of stay. Prompt transfer to a SCI-center may optimize the care trajectory by favoring earlier transfer to rehabilitation.
CONTEXT/ OBJECTIVE: Determine the impact of early admission and complete perioperative management in a specialized spinal cord injury (SCI) trauma center (SCI-center) on the occurrence of medical complications following tetraplegia. DESIGN: A retrospective comparative cohort study of prospectively collected data involving 116 individuals was conducted. Group 1 (N=87) was early managed in a SCI-center promptly after the trauma, whereas Group 2 (N=29) was surgically and preoperatively managed in a non-specialized (NS) center before being transferred to the SCI-center. Bivariate comparisons and multivariate logistic regression analyses were used to assess the relationship between the type of acute care facility and the occurrence of medical complications. Length of stay (LOS) in acute care was also compared. SETTING: Single Level-1 trauma center. PARTICIPANTS: Individuals with acute traumatic motor-complete cervical SCI. INTERVENTIONS: Not applicable Outcome measures: The occurrence of complications during the SCI-center stay. RESULTS: There was a similar rate of complications between the two groups. However, the LOS was greater in Group 2 (p=0.04). High cervical injuries (C1-C4) showed an important tendency to increase the likelihood of developing a complication, while high cervical injuries and increased trauma severity increased the odds of developing respiratory complications. CONCLUSION: Although complication rates were similar in non-specialized and specialized centers, peri-operative management in a non-specialized center required a longer length of stay. Prompt transfer to a SCI-center may optimize the care trajectory by favoring earlier transfer to rehabilitation.
Authors: Janneke A Haisma; Lucas H van der Woude; Henk J Stam; Michael P Bergen; Tebbe A Sluis; Marcel W Post; Johannes B Bussmann Journal: J Rehabil Med Date: 2007-05 Impact factor: 2.912
Authors: Jefferson R Wilson; Robert G Grossman; Ralph F Frankowski; Alexander Kiss; Aileen M Davis; Abhaya V Kulkarni; James S Harrop; Bizhan Aarabi; Alexander Vaccaro; Charles H Tator; Marcel Dvorak; Christopher I Shaffrey; Susan Harkema; James D Guest; Michael G Fehlings Journal: J Neurotrauma Date: 2012-07-31 Impact factor: 5.269
Authors: Bizhan Aarabi; James S Harrop; Charles H Tator; Melvin Alexander; Joseph R Dettori; Robert G Grossman; Michael G Fehlings; Stuart E Mirvis; Kathirkamanathan Shanmuganathan; Katie M Zacherl; Keith D Burau; Ralph F Frankowski; Elizabeth Toups; Christopher I Shaffrey; James D Guest; Susan J Harkema; Nader M Habashi; Penny Andrews; Michele M Johnson; Michael K Rosner Journal: J Neurosurg Spine Date: 2012-09
Authors: Alison K Godbolt; Maud Stenberg; Jan Jakobsson; Kimmo Sorjonen; Karolina Krakau; Britt-Marie Stålnacke; Catharina Nygren DeBoussard Journal: BMJ Open Date: 2015-05-03 Impact factor: 2.692
Authors: Teresa Pitts; Kimberly E Iceman; Alyssa Huff; M Nicholas Musselwhite; Michael L Frazure; Kellyanna C Young; Clinton L Greene; Dena R Howland Journal: J Neurophysiol Date: 2022-07-13 Impact factor: 2.974