Rehabilitation length of stay among traumatic paraplegics – A retrospective analysis

M. Srivastava, Anil Gupta, G. Yadav, Dileep Kumar, Sudhir Mishra, Sugandha Jauhari
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Abstract

Introduction: In patients with traumatic spinal cord injury (SCI), a complex interplay of sociodemographic and injury-related factors can impact on outcomes such as rehabilitation length of stay (r-LOS), functional status, and discharge following rehabilitation procedures. Every year 2.55 lakhs of people suffer from SCI globally. Objectives: To describe the r-LOS in patients with traumatic paraplegia and associated correlates. Materials and Methods: A retrospective study was conducted among traumatic paraplegics admitted in the rehabilitation unit of a government tertiary care hospital of Lucknow, Uttar Pradesh, between January 1, 2016, and December 31, 2017. All medical records of traumatic paraplegics fulfilling the inclusion criteria were used for data extraction and analysis. A data-gathering instrument was developed and was thereafter used to capture the relevant information from the patients' individual medical records. Results: Mean and median duration of r-LOS was 98.4 ± 37.2 and 98.3 (31.3) days, respectively. Significant predictors were age, employment status, location of residence, operation, and complications at/during hospitalization (P < 0.05). More than half (55.6%) of the traumatic paraplegic patients were of neurological category A. Among those who had r-LOS > 98 days, 94.2% had pressure ulcers in the sacral region, followed by 85.7% ischial and majority were grades 3 and 4. Conclusion: The most common cause of injury was falls from height. Pressure ulcer was the most common complication of paraplegics. Age, employment status, and location of residence were the epidemiological factors, while the history of operation and pressure ulcers were the clinical factors affecting the length of hospital stay.
外伤性截瘫患者康复时间的回顾性分析
在创伤性脊髓损伤(SCI)患者中,社会人口学和损伤相关因素的复杂相互作用可能影响康复住院时间(r-LOS)、功能状态和康复后出院等结果。全球每年有25.5万人患有脊髓损伤。目的:描述外伤性截瘫患者的r-LOS及其相关因素。材料与方法:对2016年1月1日至2017年12月31日期间在北方邦勒克瑙一家政府三级医院康复科住院的外伤性截瘫患者进行回顾性研究。所有符合纳入标准的外伤性截瘫病历均用于数据提取和分析。开发了一种数据收集工具,随后用于从患者的个人医疗记录中获取相关信息。结果:r-LOS的平均和中位持续时间分别为98.4±37.2天和98.3(31.3)天。年龄、就业状况、居住地、手术情况、住院时/住院期间并发症为显著预测因素(P < 0.05)。超过一半(55.6%)的外伤性截瘫患者为神经系统a类。在r-LOS患者中,94.2%在骶骨区发生压疮,其次是坐骨区,85.7%,大多数为3级和4级。结论:高空坠落伤是最常见的伤源。压疮是截瘫最常见的并发症。年龄、就业状况和居住地是影响住院时间的流行病学因素,手术史和压疮史是影响住院时间的临床因素。
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