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Retrospective case series of outcomes following spinal cord infarction
Author(s) -
New P. W.,
McFarlane C. L.
Publication year - 2012
Publication title -
european journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.881
H-Index - 124
eISSN - 1468-1331
pISSN - 1351-5101
DOI - 10.1111/j.1468-1331.2012.03702.x
Subject(s) - medicine , interquartile range , functional independence measure , rehabilitation , spinal cord injury , retrospective cohort study , spasticity , physical therapy , spinal cord , psychiatry
Background and purpose: There are very few studies of functional and rehabilitation outcomes in patients with spinal cord injury (SCI) owing to infarction. Methods: Retrospective chart review of consecutive admissions to a tertiary medical unit specializing in SCI rehabilitation, Melbourne, Australia. All admissions between 1 January 1995 and 31 December 2008 with a recent onset of SCI owing to ischaemia were included. Outcome measures included the following: demographic characteristics, American Spinal Injury Association (ASIA) Impairment Scale (AIS), length of stay (LOS), medical complications, accommodation, support services, continence, mobility and Functional Independence Measure (FIM) motor scores. Outcome measures recorded at admission, discharge and at 12 months post discharge. Results: Forty‐four patients were admitted for rehabilitation (men = 26, 59%), with a median age of 72 years (interquartile range [IQR], 62–79). On admission, 41 (93%) patients had paraplegia. The majority of patients ( n = 33, 75%) had an incomplete SCI. Aetiology was vascular in 19 (43%) patients, idiopathic in 11 (25%) and other in 14 (33%). The median LOS in rehabilitation was 85 days (IQR, 24–129). The most common complications were pain ( n = 34, 77%), urinary tract infection ( n = 25, 57%), spasticity ( n = 12, 27%), cardiac failure ( n = 11, 25%) and pneumonia ( n = 9, 20%). At rehabilitation discharge most patients ( n = 35, 80%) had no change in their AIS grade. Despite this, the FIM motor subscale on admission (median = 28; IQR, 21–34) had significantly improved ( P < 0.0000) by discharge (median = 66; IQR 42–78). Conclusion: Despite their comorbidities and limited change in AIS, these patients had significant improvement in functional abilities during impatient rehabilitation.