scholarly journals Respiratory function and respiratory complications in spinal cord injury: protocol for a prospective, multicentre cohort study in high-income countries

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e038204
Author(s):  
Anja M Raab ◽  
Martin W G Brinkhof ◽  
David J Berlowitz ◽  
Karin Postma ◽  
David Gobets ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Cohort Study ◽  
Respiratory Function ◽  
Respiratory Complications ◽  
Study Results ◽  
Cord Injury ◽  
Multicentre Research

IntroductionPneumonia is one of the leading complications and causes of death after a spinal cord injury (SCI). After a cervical or thoracic lesion, impairment of the respiratory muscles decreases respiratory function, which increases the risk of respiratory complications. Pneumonia substantially reduces patient’s quality of life, may prolong inpatient rehabilitation time, increase healthcare costs or at worse, lead to early death. Respiratory function and coughing can be improved through various interventions after SCI, but the available evidence as to which aspect of respiratory care should be optimised is inconclusive. Furthermore, ability of respiratory function parameters to predict pneumonia risk is insufficiently established. This paper details the protocol for a large-scale, multicentre research project that aims to evaluate the ability of parameters of respiratory function to predict and understand variation in inpatient risk of pneumonia in SCI.Methods and analysisRESCOM, a prospective cohort study, began recruitment in October 2016 across 10 SCI rehabilitation centres from Australia, Austria, Germany, the Netherlands and Switzerland. Inpatients with acute SCI, with complete or incomplete cervical or thoracic lesions, 18 years or older and not/no more dependent on 24-hour mechanical ventilation within the first 3 months after injury are eligible for inclusion. The target sample size is 500 participants. The primary outcome is an occurrence of pneumonia; secondary outcomes include pneumonia-related mortality and quality of life. We will use the longitudinal data for prognostic models on inpatient pneumonia risk factors.Ethics and disseminationThe study has been reviewed and approved by all local ethics committees of all participating centres. Study results will be disseminated to the scientific community through peer-reviewed journals and conference presentations, to the SCI community, other stakeholders and via social media, newsletters and engagement activities.Trial registration detailsClinicalTrials.gov NCT02891096.

scholarly journals COMPLICATIONS OF ACUTE TRAUMATIC SPINAL INJURIES IN SAINT PETERSBURG

2020 ◽  
Vol 6 (1) ◽  
pp. 33-42
Author(s):  
S. V. Lobzin ◽  
L. M. Mirzaeva
Keyword(s):  
Quality Of Life ◽  
Risk Factors ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Vertebral Fractures ◽  
Length Of Hospital Stay ◽  
Respiratory Complications ◽  
Traumatic Injuries ◽  
Cord Injury

Almost every sailor during performing his job duties aboard receives injuries of varying severity, among which the most common are deck fractures, including compression vertebral fractures, as well as open and closed vertebral fractures with spinal cord injuries. Besides the recovery of disordered functions of the spinal cord, in cases of spinal cord injury, the fight against numerous neurological, infectious and somatic complications affecting the survival and quality of life of patients is still relevant.Objective: to study the incidence of complications of traumatic injuries of the spinal cord under initial hospitalization, their impact on the length of hospital stay, to identify and evaluate the role of risk factors in the development of complications.Materials and methods. A retrospective cohort study was conducted according to the archived case histories of patients hospitalized in neurosurgical hospitals in St. Petersburg. 311 cases of acute spinal cord injury in 2012–2016 were analyzed.Results: complications not directly related to spinal cord injury, such as bronchitis, pneumonia, bedsores, sepsis, thromboembolism, urinary tract infections, postoperative wound pyogenesis and others (damage to other organs and systems), were found in one third of patients (33,8%), in half of the cases there were multiple complications (2 or more), the most frequent — respiratory (23,5%) and pressure sores (10%). Complications significantly increased the length of hospital stay. The dependence of the frequency of complications on age, the level of spinal cord damage and the severity of the injury was revealed. Risk factors such as concomitant head injury and alcohol intoxication have been found. The revealed positive effect of corticosteroids on the regression of neurological deficit was not statistically confirmed. At the same time, there was a significant increase in the frequency of respiratory complications when using corticosteroids.Conclusion: Knowledge of the factors affecting the incidence of complications, optimization of their prevention and therapy will shorten the duration of hospitalization and improve the prognosis and quality of life of patients. The issue of use of corticosteroid therapy in the acute period of traumatic injuries of the spinal cord remains debatable. When choosing therapeutic tactics for managing patients with spinal trauma, it is necessary to take into account the risk of respiratory complications and carefully evaluate the ratio of benefits to harm. 

scholarly journals Trajectory and Determinant of Functional Independence among Patient with Traumatic and Non-Traumatic Spinal Cord Injury

2018 ◽  
Vol 7 (2) ◽  
pp. 145
Author(s):  
Yudha Mathan Sakti ◽  
Astri Ferdiana ◽  
Dananjaya Putramega ◽  
Zikrina A. Lanodiyu ◽  
Galih Prasetya Sakadewa ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Life Satisfaction ◽  
Cohort Study ◽  
Lumbar Vertebra ◽  
Functional Independence ◽  
Traumatic Spinal Cord Injury ◽  
Cord Injury

<p>The level of functional independence was directly proportional to life satisfaction and quality of life in patients with spinal cord injury. By knowing the determinants that predict changes in functional independence, medical treatment and rehabilitation can be better planned to improve the patient’s quality of life. We conducted a prospective cohort study on 49 patients with spinal cord injury at Dr. Sardjito general hospital Yogyakarta from April to June 2016. The data were taken before patient underwent surgery, before discharged from the hospital, and 3 months after underwent surgery. We found that most common spinal cord injury was at the level of lumbar vertebra with 28 patients (58%). There was a positive trajectory of the patients with spinal cord injury with ASIA grade B-E classification. However, patients with spinal cord injury with ASIA classification grade A have a neutral trajectory.We conclude there was a positive trajectory between functional independence and traumatic or non-traumatic spinal cord injury except in patients with ASIA grade A classification spinal cord injury. The determinants that affected the trajectory of patients with spinal cord injury were the level of the injured vertebra and severity of the neurological deficit. </p>

scholarly journals Qualidade de vida em portadores de lesão medular: estudo de revisão de literatura

2009 ◽  
Vol 3 (4) ◽  
pp. 1050
Author(s):  
Gelson Aguiar da Silva ◽  
Juliana Neves da Costa ◽  
Thelma Leite de Araújo ◽  
Zuila Maria De Figueiredo Carvalho ◽  
Angela Maria Alves e Souza ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Nursing Care ◽  
Physical Disabilities ◽  
Well Being ◽  
Study Results ◽  
Cord Injury ◽  
People With Physical Disabilities

Objective: to identify and systematize — in the literature available in computer databases (LILACS and MEDLINE) — studies on the quality of life of people with physical disabilities from spinal cord injury in the period from 1994 to 2004. Methods: this is a descriptive and exploratory study, in which a bibliographic review was performed. The following descriptors were used: people with physical disabilities, handicapped people, spinal cord injuries, quality of life, nursing and nursing care, and 27 articles were found, which comprised the sample for the study. Results: the topics of the articles encountered were the following: well-being of individuals with spinal cord injury; the rehabilitation process; life satisfaction; performance of physical activities and life expectancy. The study indicated an overall lack of publications in the field of nursing, as well as in methodological aspects. It was found that, although improving the life quality of patients with spinal cord injury is extremely important, there is a scarcity of studies on this subject, and it should be further investigated and discussed. Conclusion: therefore, it is important to include an understanding of the subjectivity of individuals with spinal cord injury and their perception on quality of life, aimed at improving nursing care. Descriptors: quality of life; people with disabilities; spinal cord; health of disabled or incapacitated people

scholarly journals Impaired respiratory function and associations with health-related quality of life in people with spinal cord injury

Spinal Cord ◽  
2016 ◽  
Vol 54 (10) ◽  
pp. 866-871 ◽  
Author(s):  
K Postma ◽  
M W M Post ◽  
J A Haisma ◽  
H J Stam ◽  
M P Bergen ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Respiratory Function ◽  
Health Related Quality ◽  
Cord Injury ◽  
Related Quality ◽  
Health Related

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

Spinal Cord ◽  
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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