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脊髓损伤后的并发症:住院康复期间及之后纵向研究中的发生率及危险因素

Complications following spinal cord injury: occurrence and risk factors in a longitudinal study during and after inpatient rehabilitation.

作者信息

Haisma Janneke A, van der Woude Lucas H, Stam Henk J, Bergen Michael P, Sluis Tebbe A, Post Marcel W, Bussmann Johannes B

机构信息

Department of Rehabilitation Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.

出版信息

J Rehabil Med. 2007 May;39(5):393-8. doi: 10.2340/16501977-0067.

Abstract

OBJECTIVE

To assess the occurrence and risk factors for complications following spinal cord injury during and after inpatient rehabilitation.

DESIGN

Multicentre longitudinal study.

SUBJECTS

A total of 212 persons with a spinal cord injury admitted to specialized rehabilitation centres.

METHODS

Assessments at the start of active rehabilitation (n=212), 3 months later (n=143), at discharge (n=191) and 1 year after discharge (n=143).

RESULTS

Multi-level random coefficient analyses revealed that complications were common following spinal cord injury. Most subjects reported neurogenic and musculoskeletal pain, or had spasticity at each assessment. During the year after discharge, complications remained common: urinary tract infections and pressure sores affected 49% and 36% of the population, respectively. The degree of pain decreased, whereas the degree of spasticity increased significantly during inpatient rehabilitation. Overall, increased age, increased body mass index, traumatic lesion, tetraplegia, and complete lesion all increased the risk of complications.

CONCLUSION

Complications are common following spinal cord injury. They need specific attention after discharge from inpatient rehabilitation and within subpopulations.

摘要

目的

评估住院康复期间及之后脊髓损伤后并发症的发生率及危险因素。

设计

多中心纵向研究。

研究对象

共有212例脊髓损伤患者入住专门的康复中心。

方法

在积极康复开始时(n = 212)、3个月后(n = 143)、出院时(n = 191)及出院后1年(n = 143)进行评估。

结果

多层次随机系数分析显示,脊髓损伤后并发症很常见。大多数受试者在每次评估时均报告有神经源性和肌肉骨骼疼痛,或存在痉挛。出院后的一年内,并发症仍然很常见:尿路感染和压疮分别影响了49%和36%的人群。在住院康复期间,疼痛程度减轻,而痉挛程度显著增加。总体而言,年龄增加、体重指数增加、创伤性损伤、四肢瘫痪和完全性损伤均增加了并发症的风险。

结论

脊髓损伤后并发症很常见。在住院康复出院后及特定亚人群中,它们需要特别关注。

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