College of Health Professions, Medical University of South Carolina, Charleston, SC.
Shepherd Center, Atlanta, GA.
Arch Phys Med Rehabil. 2022 Apr;103(4):722-728. doi: 10.1016/j.apmr.2021.02.030. Epub 2021 May 28.
To identify the self-reported frequency of emergency department (ED) visits, ED-related hospitalizations, and reasons for ED visits among people with traumatic spinal cord injury (SCI) and compare them with general population data from the same geographic area.
Cross-sectional.
A specialty hospital in the Southeastern United States.
The participants (N=648) were community-dwelling adults (18 years and older) with a traumatic SCI, who were at least 1 year postinjury. A comparison group of 9728 individuals from the general population was retrieved from the 2017 National Health Interview Survey (NHIS).
Not applicable.
Participants completed self-report assessments on ED visits, ED hospitalizations, and reasons for ED visits in the past 12 months using items from the NHIS.
A total of 37% of participants with SCI reported at least 1 ED visit, and 18% reported at least 1 ED hospitalization in the past 12 months. Among those having at least 1 ED visit, 49% were admitted to hospitals. After controlling for sex, age, and race/ethnicity, participants with SCI were 151% more likely to visit the ED (odds ratio [OR], 2.51) and 249% more likely to have at least 1 ED hospitalization than the NHIS sample (OR, 3.49). Persons with SCI had a higher percentage of ED visits because of severe health conditions, reported an ED was the closest provider, and were more likely to arrive by ambulance. NHIS participants were more likely to visit the ED because no other option was available.
Compared with those in the general population, individuals with SCI have substantially higher rates of ED visits, yet ED visits are not regularly assessed within the SCI Model Systems. ED visits may indicate the need for intervention beyond the acute condition leading directly to the ED visits and an opportunity to link individuals with resources needed to maintain function in the community.
确定外伤性脊髓损伤（SCI）患者自我报告的急诊科（ED）就诊频率、与 ED 相关的住院率以及 ED 就诊原因，并将其与同一地理区域的一般人群数据进行比较。
横断面研究。
美国东南部的一家专科医院。
研究对象为（N=648）社区居住的成年人（18 岁及以上），他们患有外伤性 SCI，且至少在伤后 1 年。从 2017 年全国健康访谈调查（NHIS）中检索到一个由 9728 名一般人群组成的对照组。
无。
参与者使用 NHIS 中的项目，对过去 12 个月内的 ED 就诊、ED 住院和 ED 就诊原因进行自我报告评估。
共有 37%的 SCI 患者报告在过去 12 个月内至少有 1 次 ED 就诊，18%的患者报告在过去 12 个月内至少有 1 次 ED 住院。在至少有 1 次 ED 就诊的患者中，有 49%的患者被收治入院。在控制了性别、年龄和种族/民族后，与 NHIS 样本相比，SCI 患者就诊 ED 的可能性高 151%（优势比[OR]，2.51），至少有 1 次 ED 住院的可能性高 249%（OR，3.49）。SCI 患者去 ED 的比例更高，是因为他们有严重的健康状况，报告说 ED 是最近的医疗机构，而且更有可能乘坐救护车到达。NHIS 参与者更有可能去 ED，是因为没有其他选择。
与一般人群相比，SCI 患者的 ED 就诊率显著更高，但 SCI 模型系统中并未定期评估 ED 就诊情况。ED 就诊可能表明需要进行干预，不仅仅是针对直接导致 ED 就诊的急性病症，而且还有机会为患者提供在社区中维持功能所需的资源。
