2 Outcome Assessment Tools for Spinal Trauma Patients

2011 ◽  
Keyword(s):  
Outcome Assessment ◽  
Spinal Trauma ◽  
Assessment Tools ◽  
Trauma Patients

Are existing outcome instruments suitable for assessment of spinal trauma patients?

2010 ◽  
Vol 13 (5) ◽  
pp. 638-647 ◽  
Author(s):  
Agnita Stadhouder ◽  
Constantinus F. M. Buckens ◽  
Herman R. Holtslag ◽  
F. Cumhur Öner
Keyword(s):  
Outcome Assessment ◽  
Outcome Measures ◽  
Outcome Measurement ◽  
Spinal Trauma ◽  
Assessment Tools ◽  
International Classification Of Functioning ◽  
Trauma Patients ◽  
Outcome Measurements ◽  
Trauma Population ◽  
Content Coverage

Object Valid outcome assessment tools specific for spinal trauma patients are necessary to establish the efficacy of different treatment options. So far, no validated specific outcome measures are available for this patient population. The purpose of this study was to assess the current state of outcome measurement in spinal trauma patients and to address the question of whether this group is adequately served by current disease-specific and generic health-related quality-of-life instruments. Methods A number of widely used outcome measures deemed most appropriate were reviewed, and their applicability to spinal trauma outcome discussed. An overview of recent movements in the theoretical foundations of outcome assessment, as it pertains to spinal trauma patients has been attempted, along with a discussion of domains important for spinal trauma. Commonly used outcome measures that are recommended for use in trauma patients were reviewed from the perspective of spinal trauma. The authors further sought to select a number of spine trauma–relevant domains from the WHO's comprehensive International Classification of Functioning, Disability and Health (ICF) as a benchmark for assessing the content coverage of the commonly used outcome measurements reviewed. Results The study showed that there are no psychometrically validated outcome measurements for the spinal trauma population and there are no commonly used outcome measures that provide adequate content coverage for spinal trauma domains. Conclusions Spinal trauma patients are currently followed either as a subset of the polytrauma population in the acute and early postacute setting or as a subset of neurological injury in the long-term revalidation medicine setting.

scholarly journals Older trauma patients are at high risk of delirium, especially those with underlying dementia or baseline frailty

2021 ◽  
Vol 6 (1) ◽  
pp. e000639
Author(s):  
Danielle Ní Chróinín ◽  
Nevenka Francis ◽  
Pearl Wong ◽  
Yewon David Kim ◽  
Susan Nham ◽  
...  
Keyword(s):  
Older Patients ◽  
Multivariable Analysis ◽  
Primary Outcome Measure ◽  
Hospital Length ◽  
Assessment Tools ◽  
Hospital Length Of Stay ◽  
Trauma Patients ◽  
Level Of Evidence ◽  
Increased Risk ◽  
History Of

BackgroundGiven the increasing numbers of older patients presenting with trauma, and the potential influence of delirium on outcomes, we sought to investigate the proportion of such patients who were diagnosed with delirium during their stay—and patient factors associated therewith—and the potential associations between delirium and hospital length of stay (LOS). We hypothesized that delirium would be common, associated with certain patient characteristics, and associated with long hospital LOS (highest quartile).MethodsWe conducted a retrospective observational cohort study of all trauma patients aged ≥65 years presenting in September to October 2019, interrogating medical records and the institutional trauma database. The primary outcome measure was occurrence of delirium.ResultsAmong 99 eligible patients, delirium was common, documented in 23% (23 of 99). On multivariable analysis, adjusting for age, frailty and history of dementia, frailty (OR 4.09, 95% CI 1.08 to 15.53, p=0.04) and dementia (OR 5.23, 95% CI 1.38 to 19.90, p=0.02) were independently associated with likelihood of delirium. Standardized assessment tools were underused, with only 34% (34 of 99) screened within 4 hours of arrival. On univariate logistic regression analysis, having an episode of delirium was associated with long LOS (highest quartile), OR of 5.29 (95% CI 1.92 to 14.56, p<0.001). In the final multivariable model, adjusting for any (non-delirium) in-hospital complication, delirium was independently associated with long LOS (≥16 days; OR 4.81, p=0.005).DiscussionIn this study, delirium was common. History of dementia and baseline frailty were associated with increased risk. Delirium was independently associated with long LOS. However, many patients did not undergo standardized screening at admission. Early identification and targeted management of older patients at risk of delirium may reduce incidence and improve care of this vulnerable cohort. These data are hypothesis generating, but support the need for initiatives which improve delirium care, acknowledging the complex interplay between frailty and other geriatric syndromes in the older trauma patients.Level of evidenceIII.

“The feasibility and reliability of frailty assessment tools applicable in acute in-hospital trauma patients

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Charlotte I. Cords ◽  
Inge Spronk ◽  
Francesco U.S. Mattace-Raso ◽  
Michiel H.J. Verhofstad ◽  
Cornelis H. van der Vlies ◽  
...  
Keyword(s):  
Assessment Tools ◽  
Trauma Patients ◽  
Frailty Assessment

scholarly journals Long-Term Systematic Outcome Assessment of Patients Following Spine Surgery in Rwanda: The Use of Patient Reported Outcome Tools

2020 ◽  
pp. 1-11
Author(s):  
Steven Nshuti ◽  
Steven Nshuti ◽  
Beryl Guterman ◽  
David Hakizimana ◽  
Eric Buramba ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spine Surgery ◽  
Patient Reported Outcome ◽  
Severe Disability ◽  
Assessment Tools ◽  
Trauma Patients ◽  
Patient Reported ◽  
Injured Patients ◽  
Spinal Cord Injured ◽  
Trauma Group

Background: We conducted a systematic evaluation of neurological, functional, quality of life and pain outcomes of patients who underwent spine surgery in our neurosurgery unit using patient reported outcome (PRO) assessment tools. Methods: The study was performed by assessing outcome of all the patients who underwent spine surgery at our department in a cross-sectional fashion using a 5-year operative database. This was an all-inclusive spine outcome study with 2 main groups; a trauma group composed of spinal cord injured patients and a non-trauma group composed of patients with spinal degenerative diseases, spinal tumors, deformity, infection, and vascular malformations. Results: Our analysis included 197 patients who met inclusion criteria for the study. The overall study population was mainly dominated by spinal cord injured patients and spinal degenerative disease patients; 34 % and 60.9 % respectively. The average age was 42 years (range: 15-78 years) with patients in the trauma group being substantially younger than the rest of the cohort. Eighty five percent of trauma patients presented with spinal cord injury causing neurological deficit, of which 58% had no preservation of motor function below the level of injury; ASIA IS A and B (35.8% and 22% respectively). Additionally, 68% of patients in the non-trauma group underwent surgery with severe disability. Overall, 60% of all trauma patients showed improvement of their neurological status as per ASIA IS. Of note, 40% of patients with preoperative ASIA IS B and 8% of patients with preoperative ASIA IS A gained full neurological recovery postoperatively (ASIA IS E). Using the Core outcome measurement Index (COMI) from patient’s perspective, 78.6% of patients reported to have no pain significant enough to make them stop their normal daily activities. Rate of overall return to work (RTW) in the non-trauma group was 77% with 52% of patients being fully functional without condition-related work interruptions. Conclusion: Careful selection of patients for surgery is key for good outcome of patients undergoing spine surgery. In contradiction to most other patients’ groups, patients with severe disability with spinal degenerative conditions might benefit most from surgery. Postoperative outcome of spinal cord injured patients with severe neurological deficits might be better than commonly believed. Controlled prospective data is likely to draw stronger conclusions.

Comparison of Length of Hospital Stay Between Taipei City and Hualien County in Spinal Trauma Patients

2010 ◽  
Vol 2 (5) ◽  
pp. 239-244 ◽  
Author(s):  
Wei-Chen Lee ◽  
Wen-Ta Chiu ◽  
Shin-Han Tsai ◽  
Mau-Roung Lin ◽  
Shu-Fen Chu ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Spinal Trauma ◽  
Trauma Patients ◽  
Taipei City

scholarly journals (A313) Role of Physiatrists in Post Disaster Scenarios - Lessons Learned from Pakistan, China and Haiti Earthquakes

2011 ◽  
Vol 26 (S1) ◽  
pp. s105-s105
Author(s):  
F.A. Rathore ◽  
C. O'connell ◽  
J. Li
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Spinal Cord Injuries ◽  
Community Integration ◽  
Functional Restoration ◽  
Lessons Learned ◽  
Spinal Trauma ◽  
Trauma Patients ◽  
Cord Injury ◽  
Post Disaster

IntroductionPhysical Medicine and Rehabilitation is a goal oriented and patient centered specialty which focuses on functional restoration and quality of life of persons with disability. The patterns of injuries among survivors of recent disasters have, range from mild (single limb fracture) to catastrophic (spinal cord injury, amputation, traumatic brain injury). Historically physiatrists have not participated the acute disaster management phase or in the emergent post disaster rehabilitation planning. This task is usually relegated to the trauma, orthopedic and general surgeons.MethodologyAuthors had firsthand experience in the acute and emergent care and rehabilitation of trauma patients after Pakistan, China and Haiti earthquakes. An electronic literature search (English, 1965–2010, Key words: trauma, rehabilitation, disability, spinal cord injury, amputation, disaster, nerve injury) was carried out. Experience sharing through committees, online forum, and communications were conducted with physiatry colleagues internationally.ResultsIn these three recent earthquakes, Physiatrists provided direct patient care, including guidance in the evacuation of survivors with pre-existing disabilities, transport of persons with spinal trauma, treatment of wounds, fractures, pain, spinal trauma patients and persons with amputations. Physiatrists devised appropriate plans for conservative management of fractures. Education of local staff and coordination of rehabilitation was initiated. Monitoring, prevention and treatment of secondary complications including prolonged immobility, pressure ulcers, chronic pain, urinary, bowel and respiratory dysfunction was performed. Physiatrists helped in patient counseling and family education.ConclusionPhysiatrists by virtue of their training and skills are in a better position to manage the disabilities, including direction of rehabilitation and community integration, prevention of complications, and education and training of health workers and teams. Timely rehabilitation interventions for Spinal cord injuries and lower limb amputations following the Pakistan, China and Haiti earthquakes resulted in reduction in morbidity and mortality among those with catastrophic injuries.

Early Prevalence of Post-Traumatic Stress Disorder in Spinal Trauma Patients

2012 ◽  
Vol 12 (9) ◽  
pp. S51
Author(s):  
Alexander C. Ching ◽  
Lynn Marshall ◽  
Robert A. Hart ◽  
Natalie L. Zusman ◽  
Beth Darnall ◽  
...  
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Spinal Trauma ◽  
Trauma Patients ◽  
Post Traumatic Stress ◽  
Post Traumatic

Clinical Assessment of Upper Extremity Injury Outcomes

2011 ◽  
Vol 20 (1) ◽  
pp. 61-73 ◽  
Author(s):  
Charles Thigpen ◽  
Ellen Shanley
Keyword(s):  
Decision Making ◽  
Clinical Outcome ◽  
Outcome Assessment ◽  
Clinical Outcomes ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Assessment Tools ◽  
Bottom Line ◽  
Patient Scenario ◽  
Clinical Outcomes Assessment

Patient Scenario:The patient presented is a high school baseball pitcher who was unable to throw because of shoulder pain. He subsequently failed nonoperative management but was able to return to pitching after surgery and successful rehabilitation.Clinical Outcomes Assessment:The Disabilities of Arm, Shoulder and Hand (DASH) and the Pennsylvania Shoulder Score (PENN) were selected as clinical outcome assessment tools to quantify the patient’s perceived ability to perform common daily tasks and sport tasks and current symptoms such as pain and patient satisfaction.Clinical Decision Making:The DASH and PENN provide important information that can be used to target specific interventions, set appropriate patient goals, assess between-sessions changes in patient status, and quantify patients’ functional loss.Clinical Bottom Line:Best clinical practice involves the use of clinical outcome assessment tools to garner an objective measure of the impact of a patient’s disease process on functional expectations. This process should facilitate a patient-centered approach by clinicians while they select the optimal intervention strategies and establish prognostic timelines.

Initial imaging strategies in spinal trauma patients

1992 ◽  
Vol 2 (3) ◽  
pp. 273-276 ◽  
Author(s):  
Erkki M. Laasonen ◽  
Jaakko Kinnunen ◽  
Timo Paakkala
Keyword(s):  
Spinal Trauma ◽  
Trauma Patients ◽  
Initial Imaging

Trauma

2021 ◽  
pp. 795-812
Author(s):  
Douglas A. Wilkinson ◽  
Aidan C. Kingwill
Keyword(s):  
Head Trauma ◽  
Abdominal Trauma ◽  
Chest Trauma ◽  
Spinal Trauma ◽  
Trauma Patients ◽  
Paediatric Trauma ◽  
Limb Trauma ◽  
Secondary Survey ◽  
Primary Assessment

Primary assessment in trauma: ABCDE?, Airway?, Breathing?, Circulation?, Secondary survey?, Chest trauma?, Abdominal trauma?, Head trauma?, Spinal trauma?, Limb trauma?, Burns?, Pregnant trauma patients?, Paediatric trauma?

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