Document Detail


Long-term medical complications after traumatic spinal cord injury: a regional model systems analysis.
MedLine Citation:
PMID:  10569434     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To analyze the incidence, risk factors, and trends of long-term secondary medical complications in individuals with traumatic spinal cord injury. DESIGN: Data were reviewed from the National SCI Statistical Center on annual evaluations performed at 1, 2, 5, 10, 15, and 20 years after injury on patients injured between 1973 and 1998. SETTING: Multicenter Regional SCI Model Systems. MAIN OUTCOME MEASURES: Secondary medical complications at annual follow-up years, including pneumonia/atelectasis, autonomic dysreflexia, deep venous thrombosis, pulmonary embolism, pressure ulcers, fractures, and renal calculi. RESULTS: Pressure ulcers were the most frequent secondary medical complications in all years, and individuals at significant (p < .05) risk included those with complete injuries (years 1, 2, 5, 10), younger age (year 2), concomitant pneumonia/atelectasis (year 1, 2, 5), and violent injury (years 1, 2, 5, 10). The incidence of pneumonia/atelectasis was 3.4% between rehabilitation discharge and year-1 follow-up with those most significantly at risk being older than 60 years (years 1, 2, 5, 10) and tetraplegia-complete (years 1, 2). One-year incidence of deep venous thrombosis was 2.1% with a significant decline seen at year 2 (1.2%), and individuals most significantly (p < .001) at risk were those with complete injuries (year 1). The incidence of calculi (kidney and/or ureter) was 1.5% at 1-year follow-up and 1.9% at 5 years and was more frequent in patients with complete tetraplegia. Intermittent catheterization was the most common method of bladder management among patients with paraplegia but became less common at later postinjury visits. CONCLUSIONS: Pressure ulcers, autonomic dysreflexia, and pneumonia/atelectasis were the most common long-term secondary medical complications found at annual follow-ups. Risk factors included complete injury, tetraplegia, older age, concomitant illness, and violent injury.
Authors:
W O McKinley; A B Jackson; D D Cardenas; M J DeVivo
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, U.S. Gov't, Non-P.H.S.    
Journal Detail:
Title:  Archives of physical medicine and rehabilitation     Volume:  80     ISSN:  0003-9993     ISO Abbreviation:  Arch Phys Med Rehabil     Publication Date:  1999 Nov 
Date Detail:
Created Date:  1999-12-07     Completed Date:  1999-12-07     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  2985158R     Medline TA:  Arch Phys Med Rehabil     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1402-10     Citation Subset:  AIM; IM    
Affiliation:
Department of Physical Medicine & Rehabilitation, Medical College of Virginia/Virginia Commonwealth University, Richmond 23298, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Autonomic Dysreflexia / epidemiology*,  etiology
Child
Databases, Factual / statistics & numerical data*
Female
Humans
Incidence
Injury Severity Score
Male
Middle Aged
Multicenter Studies as Topic
Pressure Ulcer / epidemiology*,  etiology
Prevalence
Pulmonary Atelectasis / epidemiology*,  etiology
Risk Factors
Spinal Cord Injuries / classification,  complications*
Time Factors
United States / epidemiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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