scholarly journals Factors affecting length of hospital stay for people with spinal cord injuries at Kanombe military hospital, Rwanda

2012 ◽  
Vol 68 (2) ◽  
Author(s):  
PB Bwanjugu ◽  
A. Rhoda

In patients with spinal cord injuries increased length ofhospital stay is often as a result of secondary complications such as pressuresores, urinary tract infection and respiratory infection. An increased lengthof hospital stay was observed at Kanombe Military Hospital in Rwanda.The aim of this study was to determine specific factors affecting length ofhospital stay for individuals with spinal cord injuries at Kanombe MilitaryHospital in Rwanda. The records of 124 individuals with spinal cordinjuries who were discharged from the hospital between 1st January1996and 31st December 2007 were reviewed to collect data. Information collected and captured on a data gathering sheetincluded demographic data, information relating to the injury, occurrence of medical complications and length ofhospital stay. Linear regression analysis was computed in SPSS to determine factors affecting the length of stay.The necessary ethical considerations were adhered to during the implementation of the study. Current employmentstatus and the occurrence of pressure sores were significantly associated with the length of hospital stay (p=0.021 andp=0.000 respectively). A strong relationship was noted between pressure sores and length of stay (R= 0.703). There is aneed for all members of the rehabilitation team to devise and implement effective measures to prevent the developmentof pressure sores, in patients with spinal cord injuries in the study setting.

2020 ◽  
Vol 27 (1) ◽  
pp. 59-71
Author(s):  
Lyudmila M. Mirzaeva ◽  
Sergei V. Lobzin ◽  
Inga V. Chistova ◽  
Olga A. Rizahanova ◽  
Alexander A. Dulaev

Background. One of the most common causes of death is trauma. The World Health Organization predicts a 40 % increase in injuries and injury-related deaths over the next 10 years. Despite the achievements of modern medicine, mortality in spine and spinal cord injuries remains high. This is explained not only by the severity of traumas, but also a large number of secondary complications,.Aim. To study the frequency of complications and the mortality rate of traumatic spinal cord injuries; to identify factors affecting the outcome of such injuries. Materials and methods. A retrospective analysis covered 322 medical records from patients diagnosed with traumatic spinal cord injury and admitted to neurosurgical departments of Saint Petersburg in 2012–2016.Results. Secondary complications (outside of the central nervous system) were found in 33 % cases, with the most common and serious being respiratory complications, pressure ulcers and thromboembolism. Complications more often occurred in elderly patients (over 75), as well as in severe injuries at the cervical and thoracic level. Complications developed significantly more frequently in patients with concomitant traumatic brain injury (TBI) and persons with alcohol consumption before injury. Complications noticeably increased the length of hospital stay and increased the risk of death by 43 times. 14 % of the patients died during primary stay in hospital. The spinal cord injury incompatible with life occurred only in 1 % of the patients. The lethal outcome correlated with age, severity, level of injury, concomitant TBI and alcohol consumption.Conclusion. We have found a high incidence of unfavourable outcomes for traumatic spinal cord injuries (every third patient had at least one complication, every seventh died during the primary hospitalisation). In addition to unmodifiable factors, a statistically significant negative role of alcohol in the frequency of complications and death after spinal cord injury was found. Promoting a healthy lifestyle with low alcohol consumption, optimising preventive and therapeutic measures aimed at reducing the frequency of infectious and thromboembolic complications will improve the outcome of traumatic spinal cord injuries, reduce the length of hospital stay and decrease the economic burden of spinal cord injuries. 


Author(s):  
Dr.Randa Mohammed AboBaker

Postoperative Ileus (POI) is one of the most common problems after obstetrics, gynecologic and abdominal surgeries. Sham feeding, such as gum chewing, accelerates the return of bowel function and the length of hospital stay. The present study aims to evaluate the effect of chewing gum on bowel motility in women undergoing post-operative cesarean section. Intervention study was used at the Postpartum Department of Maternity and Children Hospital, KSA. A randomized controlled clinical trial research design. Through a convenience technique, 80 post Caesarian Section (CS) women were included in the study. Data were collected through three tools: Tool (I): Socio-demographic data and reproductive history interview schedule. Tool (II): Postoperative Assessment Sheet. Tool (III): Outcomes of gum chewing and the length of hospital stay.  Method: subjects were assigned randomly into two groups of (40) the experimental and (40) the control. Subjects in the study group were asked to chew two pieces of sugarless gum for 30 min/three times daily in the morning, noon, and evening immediately after recovery from anesthesia and in Postpartum Department; while subjects in the control group followed the hospital routine care. Each woman in both groups was tested abdominally using a stethoscope to auscultate the bowel sounds and asked to report immediately the time of either passing flatus or stool. Results: illustrated that a highly statistically significant difference was observed between the two groups concerning their gum chewing outcomes. Where, P = 0.000. The study concluded that gum chewing is safe, well tolerated and appears to be effective in reducing the incidence and consequences of POI following CS.


2021 ◽  
Vol 29 (1) ◽  
pp. 230949902098821
Author(s):  
Md Kamrul Ahsan ◽  
Md Sariful Hasan ◽  
Md Shahidul Islam Khan ◽  
Najmus Sakeb

Purpose: To perform retrospective analysis of 75 post-operative disc space infections after open lumbar discectomy (OLD) and to assess the outcome of their medical and surgical management in a tertiary-level hospital. Methods: Records of 50 men and 25 women aged 26–65 (mean, 42.53) years who underwent treatment for post-operative discitis (POD) after single level OLD at L3–4 (n = 8), L4–5 (n = 42), L5–S1 (n = 25) level. The POD was diagnosed according to specific clinical signs, laboratory and radiographic investigations and all of them received initial intravenous antibiotics (IVA) for at least 4–6 weeks followed by oral ones. Successful responders (n = 55) were considered in Group-C and remainder [Group-S (n = 20)] were operated at least after 4 weeks of failure. Demographic data, clinical variables, hospital stay, duration of antibiotic treatment and post-treatment complications were collected from the hospital record and assessment before and after treatment were done by using visual analogue scale (VAS) and Japanese Orthopaedic Association (JOA) score. Comprehensive outcome was evaluated by modified criteria of Kirkaldy-Willis. Results: The mean follows up was 36.38 months. Significant improvement of mean VAS and JOA score was achieved in both conservative (76.36% satisfactory) and operative (90% satisfactory) groups although the difference was statistically insignificant. Conclusion: Although insignificant, early surgical intervention provided better results (e.g. functional outcomes, length of hospital stay and duration of antibiotic treatment therapy) than conventional conservative treatment in post-operative discitis.


Author(s):  
Çağla Koç ◽  
Füsun Şahin

INTRODUCTION: The aim of this study was to investigate the important factors affecting the COPD prognosis. MATERIAL AND METHODS: We included 160 hospitalized patients with COPD exacerbation in the study. Hemoglobin-HB, hematocrit-HCT, leukocyte, red cell distribution width- RDW, mean platelet volume, platelet distribution width, plateletcrit, platelet, neutrophil / lymphocyte ratio, platelet / lymphocyte ratio, eosinophil, uric acid, albumin, CRP, procalcitonin, arterial blood gases (PO2, PCO2) pulmonary function test (FEV1, FVC), echocardiography (ejection fraction-EF) GOLD stage, MMRC and BORG scales, Charlson comorbidity index, body mass index-BMI, length of hospital stay were examined on the first day of hospitalization. Admission to the hospital with a new attack, hospitalization in the intensive care unit-ICU, and mortality during the 6 months after discharge were evaluated. RESULTS: High CRP and procalcitonin values were observed in the group with long hospital stay. In mortality group, HB, HCT, BMI and PO2 values were significantly lower than the group without mortality while age and GOLD stage were higher. The age, BORG and MMRC scores, number of exacerbations experienced in the previous 1 year, RDW, eosinophil count, PCO2 were significantly higher in the ICU group than without ICU. HCT, EF values were lower in the ICU group than without ICU. FEV1, FVC values were significantly lower in follow-up attack group than without attack; the duration of COPD and the number of experienced in the previous 1 year were high. CONCLUSION: It has been concluded that the scoring combining selected biomarkers and other factors will be stronger in determining the prognosis.


BMJ ◽  
1978 ◽  
Vol 1 (6127) ◽  
pp. 1622-1623
Author(s):  
D Phillips-Miles

1986 ◽  
Vol 314 (3) ◽  
pp. 153-157 ◽  
Author(s):  
Robert S. Rhodes ◽  
Carl L. Krasniak ◽  
Paul K. Jones

2009 ◽  
Vol 11 (4) ◽  
pp. 480-486 ◽  
Author(s):  
Cheng-Chih Liao ◽  
Po-Chuan Hsieh ◽  
Tzu-Kang Lin ◽  
Chih-Lung Lin ◽  
Yang-Lan Lo ◽  
...  

Object Spontaneous spinal epidural hematoma (SSEH) is a rare disease. The goal of this study was to clarify the treatment results and management options in SSEH. Methods Patients with SSEH who were surgically treated in the authors' center between June 2003 and June 2008 were included in this study. Patients were treated as early as possible if their neurological deficits were incomplete or had been complete for 12 hours or less. The patients were assigned to 1 of 2 groups based on completeness of preoperative cord dysfunction (complete vs incomplete deficit). Surgical outcomes of the 2 groups were compared by functional performance, coded as Nurick grades at 1, 3, and 6 months after the operation. Also compared were duration of hospital stay and the number of days needed to regain the ability to function independently (defined as Nurick Grades 1 and 2) after the operation. Results There were 17 patients (7 female and 10 male) with pathologically confirmed SSEH. Coagulopathy, greater size (length) of SSEH, and preoperative complete spinal dysfunction were found to contribute to poor postoperative functional recovery (p < 0.05). Patients with incomplete preoperative deficits (ASIA Impairment Scale Grades B, C, and D) were able to achieve functional independent recovery within a month after surgery and had significantly better outcomes (lower Nurick grades) at 1, 3, and 6 months postoperatively than those with complete deficits (p < 0.001, p = 0.027, and p = 0.027, respectively). Median time to independent functional recovery and median length of hospital stay were significantly shorter in patients with incomplete preoperative deficits than in those with complete deficits (6 vs 110 and 9 vs 58 days, respectively; both p < 0.001). Conclusions Impaired preoperative hemostasis contributes to larger size of SSEH, high probability of postoperative recurrence of spinal epidural hematoma, and poor functional recovery following surgical evacuation. Incomplete spinal cord dysfunction before surgery predicts good outcome and warrants emergent evacuation of SSEH especially in the cervical and thoracic regions, where the clots are located in proximity to the spinal cord.


2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Phonthep Angsuwatcharakon ◽  
Piyapan Prueksapanich ◽  
Pradermchai Kongkam ◽  
Thawee Rattanachu-ek ◽  
Jaksin Sottisuporn ◽  
...  

Aim. To study the efficacy and other treatment outcomes of Ovesco clip closure of iatrogenic perforation. Methods. Retrospective study from 3 tertiary-care hospitals in Thailand. Patients with iatrogenic perforation who underwent immediate endoscopic closure by Ovesco clip were included. Patients’ demographic data, perforation size, number of Ovesco clips used, fasting day, length of hospital stay, success rates, and complication rate were recorded. Technical success was defined as closure achievement during endoscopic procedure and clinical success was defined as the patient can be discharged without the need of additional surgical or radiological intervention. Results. There were 6 iatrogenic perforations in 2 male and 4 female patients. The median age was 59 years (range 39–78 years). The locations of perforation were 5 duodenal walls and 1 rectosigmoid junction. The median perforation size was 13 mm (range 10–40 mm). The technical success was 100% and the clinical success was 83.3%. The success rates per locations were 100% in colon and 80% in duodenum, respectively. The median fasting time was 5 days (range 1–10 days) and the median length of hospital stay was 10 days (range 2–22 days). There was no mortality in any. Conclusion. Ovesco clip seems to be an effective and safe tool for a closure of iatrogenic perforation.


1981 ◽  
Vol 37 (4) ◽  
pp. 93-95
Author(s):  
Lane Flint

The incidence of spinal cord injuries in industrial countries is increasing. Rehabilitation and vocational (re)training of these persons in wheelchairs is essential. This article describes a specific rehabilitation programme from the acute phase to the final goal, namely vocational integration. All members of the rehabilitation team are involved.


1999 ◽  
Vol 35 ◽  
pp. 302-303
Author(s):  
Kaoru Fujiie ◽  
Kiyomi Matuo ◽  
Yoshiteru Terashi ◽  
Hiromitu Kobayashi

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