An Antimicrobial Stewardship Initiative to Evaluate Penicillin Allergy Labels in Spinal Cord Injury and Long-Term Care Patients

Neurologic rehabilitation arguably starts in the neurosciences intensive care unit. Specialized care is often needed in acute spinal cord injury, particularly if long-term care appears imminent. Much of neurorehabilitation is done without pharmaceuticals, but good options are available in patients with persistent disorders of consciousness, spasticity, and early depression after stroke. Disorders of consciousness are major concerns in neurorehabilitation centers because they obviate traditional rehabilitation programs. Improvement can be achieved with a neurostimulant which would improve attention span to therapy This chapter discusses dopaminergic agents and other neurostimulants for disorders of consciousness and long-term drugs for spasticity to improve outcomes.

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Attrition from specialised rehabilitation associated with an elevated mortality risk: results from a vital status tracing study in Swiss spinal cord injured patients

BMJ Open ◽

10.1136/bmjopen-2019-035752 ◽

2020 ◽

Vol 10 (7) ◽

pp. e035752

Author(s):

Jonviea D Chamberlain ◽

Inge E Eriks-Hoogland ◽

Kerstin Hug ◽

Xavier Jordan ◽

Martin Schubert ◽

...

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Cohort Study ◽

Community Dwelling ◽

Term Care ◽

Term Survival ◽

Vital Status ◽

Risk Of Mortality ◽

Cord Injury

IntroductionStudy drop-out and attrition from treating clinics is common among persons with chronic health conditions. However, if attrition is associated with adverse health outcomes, it may bias or mislead inferences for health policy and resource allocation.MethodsThis retrospective cohort study uses data attained through the Swiss Spinal Cord Injury (SwiSCI) cohort study on persons with spinal cord injury (SCI). Vital status (VS) was ascertained either through clinic medical records (MRs) or through municipalities in a secondary tracing effort. Flexible parametric survival models were used to investigate risk factors for going lost to clinic (LTC) and the association of LTC with subsequent risk of mortality.Results1924 individuals were included in the tracing study; for 1608 of these cases, contemporary VS was initially checked in the MRs. VS was ascertained for 704 cases of the 1608 cases initially checked in MRs; of the remaining cases (n=904), nearly 90% were identified in municipalities (n=804). LTC was associated with a nearly fourfold higher risk of mortality (HR=3.62; 95% CI 2.18 to 6.02) among persons with traumatic SCI. Extended driving time (ie, less than 30 min compared with 30 min and longer to reach the nearest specialised rehabilitation facility) was associated with an increased risk of mortality (HR=1.51, 95% CI 1.02 to 2.22) for individuals with non-traumatic SCI.ConclusionThe differential risk of LTC according to sociodemographic and SCI lesion characteristics underscores the importance of accounting for attrition in cohort studies on chronic disease populations requiring long-term care. In addition, given the associated risk of mortality, LTC is an issue of concern to clinicians and policy makers aiming to optimise the long-term survival of community-dwelling individuals with traumatic SCI. Future studies are necessary to verify whether it is possible to improve survival prospects of individuals LTC through more persistent outreach and targeted care.

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1232: Long-Term Urodynamic Follow-Up in Patients with Spinal Cord Injury: Is it Really Necessary

The Journal of Urology ◽

10.1016/s0022-5347(18)35377-1 ◽

2005 ◽

Vol 173 (4S) ◽

pp. 334-334

Author(s):

Juergen Pannek ◽

Michael Nosseir

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Cord Injury

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Long-Term Follow-Up After Spinal Cord Injury in Canada

PsycEXTRA Dataset ◽

10.1037/e513252007-001 ◽

2006 ◽

Author(s):

Mark I. Tonack ◽

Sander L. Hitzig ◽

B. Catharine Craven ◽

Kent A. Campbell ◽

Kathryn A. Boschen ◽

...

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Cord Injury ◽

Long Term Follow Up

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OPEN HAEMORRHOIDS SURGERY IN SPINAL CORD INJURY PATIENTS

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v4i11.1532 ◽

2020 ◽

Vol 4 (11) ◽

Author(s):

Khaled Hassan

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Anal Fissure ◽

Open Surgery ◽

Anal Fissures ◽

Cord Injury ◽

Long Term Follow Up ◽

Grade Iii

This Pilot retrospective research conducted on the results of open surgery in patients with Grade III and IV haemorrhoids With SCI. No major complications had arisen at 6 weeks post-operative and all wounds had healed, but 1 patient Anal fissure recurrence. 75% of patients reported a substantial increase in anorectal anorexia during long-term follow-up. With symptoms. Five patients reported recurrences: three haemorrhoids (18 percent) and two anal fissures (25 percent). Keywords: Haemorrhoids, Pilot retrospective research, Anorectal Anorexia.

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Faculty Opinions recommendation of Urine leakage in persons with spinal cord injury and using long-term Foley catheters: a simple solution.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.7384957.7658055 ◽

2010 ◽

Author(s):

Jean-Jacques Wyndaele

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Simple Solution ◽

Cord Injury ◽

Urine Leakage

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Long term outcome of functional independence and quality of life after traumatic SCI in Germany

Spinal Cord ◽

10.1038/s41393-021-00659-9 ◽

2021 ◽

Author(s):

Florian Möller ◽

Rüdiger Rupp ◽

Norbert Weidner ◽

Christoph Gutenbrunner ◽

Yorck B. Kalke ◽

...

Keyword(s):

Quality Of Life ◽

Spinal Cord ◽

Spinal Cord Injury ◽

Functional Independence ◽

Term Outcome ◽

Long Term Outcome ◽

Cord Injury ◽

Over Time

Abstract Study design Multicenter observational study. Objective To describe the long-term outcome of functional independence and quality of life (QoL) for individuals with traumatic and ischemic SCI beyond the first year after injury. Setting A multicenter study in Germany. Methods Participants of the European multicenter study about spinal cord injury (EMSCI) of three German SCI centers were included and followed over time by the German spinal cord injury cohort study (GerSCI). Individuals’ most recent spinal cord independence measure (SCIM) scores assessed by a clinician were followed up by a self-report (SCIM-SR) and correlated to selected items of the WHO short survey of quality of life (WHO-QoL-BREF). Results Data for 359 individuals were obtained. The average time passed the last clinical SCIM examination was 81.47 (SD 51.70) months. In total, 187 of the 359 received questionnaires contained a completely evaluable SCIM-SR. SCIM scores remained stable with the exception of reported management of bladder and bowel resulting in a slight decrease of SCIM-SR of −2.45 points (SD 16.81). SCIM-SR scores showed a significant correlation with the selected items of the WHO-QoL-BREF (p < 0.01) with moderate to strong influence. Conclusion SCIM score stability over time suggests a successful transfer of acquired independence skills obtained during primary rehabilitation into the community setting paralleled by positively related QoL measurements but bladder and bowel management may need special attention.

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