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创伤性脊髓损伤合并康复期获得性尿路感染的功能结局评估:一项回顾性研究。

Evaluation of functional outcomes in traumatic spinal cord injury with rehabilitation-acquired urinary tract infections: A retrospective study.

作者信息

Stampas Argyrios, Dominick Elizabeth, Zhu Liang

机构信息

Department of PM&R University of Texas Health Science Center at Houston, TIRR Memorial Hermann , Houston , Texas, USA.

The Burke Rehabilitation Hospital , White Plains , New York, USA.

出版信息

J Spinal Cord Med. 2019 Sep;42(5):579-585. doi: 10.1080/10790268.2018.1452389. Epub 2018 Apr 3.

Abstract

OBJECTIVE

The objective of this study was to evaluate the impact of urinary tract infections (UTIs) acquired during acute inpatient traumatic Spinal Cord Injury (tSCI) rehabilitation on Functional Independence Measure (FIM) gains.

DESIGN

Retrospective chart review of consecutive patients with tSCI admitted to an acute rehabilitation facility from 2007-2012. The primary outcome was FIM scores and the association with UTI.

RESULTS

The sample included 110 patients and 70 acquired UTIs. No demographic differences were observed between groups with and without UTI. Those with UTIs had significantly lower FIM motor scores, on admission, discharge, and gain, as well as lower FIM efficiency and longer lengths of stay compared to those without a UTI. Recurrence of UTI was associated with increased length of stay, but did not impact FIM motor gains.

CONCLUSIONS

There was a statistically significant correlation between acquired UTIs and lower FIM motor scores on admission, gain, and discharge in tSCI rehabilitation. The correlation of UTI and decreased FIM gains are similar to other neurorehabilitation populations with UTI occurrence. UTIs are an important negative variable when measuring functional outcomes in rehabilitation. Further prospective studies should be performed to investigate this correlation.

摘要

目的

本研究的目的是评估急性住院创伤性脊髓损伤(tSCI)康复期间获得性尿路感染(UTI)对功能独立性测量(FIM)改善的影响。

设计

对2007年至2012年入住急性康复机构的连续tSCI患者进行回顾性病历审查。主要结果是FIM评分及其与UTI的关联。

结果

样本包括110名患者,其中70名获得了UTI。有UTI和无UTI的组之间未观察到人口统计学差异。与无UTI的患者相比,有UTI的患者在入院、出院时的FIM运动评分以及评分改善明显更低,FIM效率也更低,住院时间更长。UTI复发与住院时间延长相关,但不影响FIM运动评分改善。

结论

在tSCI康复中,获得性UTI与入院、评分改善和出院时较低的FIM运动评分之间存在统计学上的显著相关性。UTI与FIM评分改善降低之间的相关性与其他发生UTI的神经康复人群相似。在康复中测量功能结果时,UTI是一个重要的负面变量。应进行进一步的前瞻性研究以调查这种相关性。

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