PMID- 23718823
OWN - NLM
STAT- MEDLINE
DCOM- 20140128
LR  - 20240321
IS  - 1757-7241 (Electronic)
IS  - 1757-7241 (Linking)
VI  - 21
DP  - 2013 May 30
TI  - Impact of multiple injuries on functional and neurological outcomes of patients 
      with spinal cord injury.
PG  - 42
LID - 10.1186/1757-7241-21-42 [doi]
AB  - BACKGROUND: The effects of multiple injuries on the neurological and functional 
      outcomes of patients with traumatic spinal cord injury (SCI) are debated-some 
      groups have shown that subjects with multiple injuries have the same neurological 
      and functional outcomes of those without them, whereas others have found that SCI 
      patients with associated traumatic brain injury have worse functional status at 
      admission and discharge and longer rehabilitation stays than patients without 
      brain injury. Thus, the aim of this study was to compare the outcomes of SCI 
      subjects with or without multiple injuries. METHODS: A total of 245 patients with 
      a traumatic SCI during the first rehabilitation stay after the development of the 
      lesion (202 males and 43 females; age 39.8 +/- 17 years; lesion to admission time 
      51.1 +/- 58 days) were examined on a referral basis. Patients were assessed using 
      the following measures: American Spinal Injury Association standards, Barthel 
      Index, Rivermead Mobility Index, and Walking Index for Spinal Cord Injury. The 
      statistical analysis comprised Poisson regression models with relative risks and 
      95% confidence intervals, adjusted for the following confounders: age, sex, 
      lesion level, and ASIA impairment scale (AIS) grade. Student's T test was used to 
      compare the outcomes of patients divided by AIS impairment and lesion level. 
      RESULTS: SCI patients with and without multiple injuries differed significantly 
      with regard to the level and completeness of the lesion. Overall, patients with 
      multiple injuries had worse functional status at admission and discharge than 
      monotraumatic subjects. However, when adjusted for neurological features, the 
      populations had comparable functional and neurological status at admission and 
      discharge and similar rates of complications and discharge destinations. The 
      separate analysis per each level of lesion/AIS grade showed that in some groups, 
      patients with multiple injuries had a significant longer length of stay or worse 
      functional status at rehabilitation admission (but not at discharge) than their 
      monotraumatic counterparts. CONCLUSIONS: Multiple injuries do not affect the 
      neurological or rehabilitative prognosis of spinal cord injuries. At discharge, 
      patients with spinal cord injuries with and without multiple injuries achieved 
      similar results with regard to neurological and functional improvement. Some 
      groups of patients with multiple injuries had a longer length of stay.
FAU - Scivoletto, Giorgio
AU  - Scivoletto G
AD  - Spinal Cord Unit, IRCCS S, Lucia Foundation, Rome, Italy. 
      g.scivoletto@hsantalucia.it
FAU - Farchi, Sara
AU  - Farchi S
FAU - Laurenza, Letizia
AU  - Laurenza L
FAU - Tamburella, Federica
AU  - Tamburella F
FAU - Molinari, Marco
AU  - Molinari M
LA  - eng
PT  - Comparative Study
PT  - Journal Article
DEP - 20130530
PL  - England
TA  - Scand J Trauma Resusc Emerg Med
JT  - Scandinavian journal of trauma, resuscitation and emergency medicine
JID - 101477511
SB  - IM
MH  - Adult
MH  - Cervical Vertebrae/injuries
MH  - Female
MH  - Humans
MH  - Length of Stay
MH  - Lumbar Vertebrae/injuries
MH  - Male
MH  - Middle Aged
MH  - Multiple Trauma/*therapy
MH  - *Recovery of Function
MH  - Retrospective Studies
MH  - Spinal Cord Injuries/rehabilitation/*therapy
MH  - Thoracic Vertebrae/injuries
MH  - Treatment Outcome
PMC - PMC3669625
EDAT- 2013/05/31 06:00
MHDA- 2014/01/29 06:00
PMCR- 2013/05/30
CRDT- 2013/05/31 06:00
PHST- 2013/01/18 00:00 [received]
PHST- 2013/05/26 00:00 [accepted]
PHST- 2013/05/31 06:00 [entrez]
PHST- 2013/05/31 06:00 [pubmed]
PHST- 2014/01/29 06:00 [medline]
PHST- 2013/05/30 00:00 [pmc-release]
AID - 1757-7241-21-42 [pii]
AID - 10.1186/1757-7241-21-42 [doi]
PST - epublish
SO  - Scand J Trauma Resusc Emerg Med. 2013 May 30;21:42. doi: 10.1186/1757-7241-21-42.