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An audit of current practice and management of metastatic spinal cord compression at a regional cancer centre.
MedLine Citation:
PMID:  21675093     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
Metastatic spinal cord compression (MSCC) is an oncological emergency requiring prompt recognition and management to preserve neurological function and mobility. We performed an audit to assess current practice of MSCC against current best practice as outlined by NICE. Our retrospective audit identified 10 patients from January to December 2009 with confirmed MSCC. The most common primary tumours were prostate 3 (30%), breast 3 (30%) and lung 2 (20%). Pain was the main presenting symptom 9 (90%), followed by weakness 7 (70%) and sensory changes 1 (10%). 5 (50%) had MRI within 24 hours and only 6 (60%) underwent full MRI scan. 8 (80%) had corticosteroids before MRI scan. 6 (60%) received radiotherapy within 24 hours. Only 4 (40%) were referred to orthopaedics and none of these patients had been recommended surgery. Up 14 days following radiological confirmation of MSCC, the number of patients who were unable to walk increased by 20%. Only 5 (50%) were discharged during this period of study. Our audit reported a number of variances in management compared to NICE guideline. These can be improved by following a'fast track' referral pathway and regular education for junior doctors and primary care doctors.
Authors:
J Sui; J S Fleming; M Kehoe
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Irish medical journal     Volume:  104     ISSN:  0332-3102     ISO Abbreviation:  Ir Med J     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-06-15     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0430275     Medline TA:  Ir Med J     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  111-4     Citation Subset:  IM    
Affiliation:
Waterford Regional Hospital, Dunmore Road, Waterford. slsui@yahoo.com
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