New P W, Astrakhantseva I
1] Spinal Rehabilitation Unit, Caulfield Hospital, Alfred Health, Melbourne, Victoria, Australia [2] Epworth-Monash Rehabilitation Medicine Unit, Monash University, Melbourne, Victoria, Australia.
Spinal Rehabilitation Unit, Caulfield Hospital, Alfred Health, Melbourne, Victoria, Australia.
Spinal Cord. 2014 Jun;52(6):444-8. doi: 10.1038/sc.2014.29. Epub 2014 Mar 25.
Retrospective, open-cohort, consecutive case series.
To describe the demographic characteristics, clinical features and outcomes in patients undergoing initial in-patient rehabilitation after an infectious cause of spinal cord myelopathy.
Spinal Rehabilitation Unit, Melbourne, Victoria, Australia. Admissions between 1 January 1995 and 31 December 2010.
The following data were recorded: aetiology of spinal cord infection, risk factors, rehabilitation length of stay (LOS), level of injury (paraplegia vs tetraplegia), complications related to spinal cord damage and discharge destination. The American Spinal Injury Association (ASIA) Impairment Scale (AIS) and functional independence measure (FIM) were assessed at admission and at discharge.
Fifty-one patients were admitted (men=32, 62.7%) with a median age of 65 years (interquartile range (IQR) 52-72, range 22-89). On admission, 37 (73%) had paraplegic level of injury and most patients (n=46, 90%) had an incomplete grade of spinal damage. Infections were most commonly bacterial (n=47, 92%); the other causes were viral (n=3, 6%) and tuberculosis (n=1, 2%). The median LOS was 106 days (IQR 65-135). The most common complications were pain (n=47, 92%), urinary tract infection (n=27, 53%), spasticity (n=25, 49%) and pressure ulcer during acute hospital admission (n=19, 37%). By the time of discharge from rehabilitation, patients typically showed a significant change in their AIS grade of spinal damage (P<0.001). They also showed significant improvement (P<0.001) in their FIM motor score (at admission: median=27, IQR 20-34; at discharge: median=66, IQR 41-75).
Most patients returned home with a good level of functioning with respect to mobility, bladder and bowel status, and their disability improved significantly.
回顾性、开放队列、连续病例系列研究。
描述脊髓病感染性病因后接受首次住院康复治疗患者的人口统计学特征、临床特征及预后。
澳大利亚维多利亚州墨尔本的脊髓康复科。1995年1月1日至2010年12月31日期间收治的患者。
记录以下数据：脊髓感染病因、危险因素、康复住院时间（LOS）、损伤平面（截瘫与四肢瘫）、与脊髓损伤相关的并发症及出院去向。入院时及出院时评估美国脊髓损伤协会（ASIA）损伤分级量表（AIS）和功能独立性测量（FIM）。
共收治51例患者（男性32例，占62.7%），中位年龄65岁（四分位间距（IQR）52 - 72岁，范围22 - 89岁）。入院时，37例（73%）为截瘫损伤平面，大多数患者（n = 46，90%）脊髓损伤分级为不完全性。感染最常见的病因是细菌（n = 47，92%）；其他病因是病毒（n = 3，6%）和结核（n = 1，2%）。中位住院时间为106天（IQR 65 - 135天）。最常见的并发症是疼痛（n = 47，92%）、尿路感染（n = 27，53%）、痉挛（n = 25，49%）以及急性住院期间的压疮（n = 19，37%）。到康复出院时，患者的脊髓损伤AIS分级通常有显著变化（P < 0.001）。他们的FIM运动评分也有显著改善（P < 0.001）（入院时：中位值 = 27，IQR 20 - 34；出院时：中位值 = 66，IQR 41 - 75）。
大多数患者出院回家时在活动能力、膀胱和肠道状况方面功能良好，残疾状况有显著改善。
