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健康行为与创伤性脊髓损伤后急诊就诊和住院的关系。

The relationship between health behaviors and emergency department visits and hospitalizations after traumatic spinal cord injury.

机构信息

College of Health Professions, Medical University of South Carolina, Charleston, SC, USA.

出版信息

Spinal Cord. 2022 May;60(5):428-434. doi: 10.1038/s41393-022-00791-0. Epub 2022 Mar 23.

Abstract

STUDY DESIGN

Cross-sectional study.

OBJECTIVE

To identify demographic, injury, and behavioral predictors of emergency department (ED) visits and ED-related hospitalizations among individuals with chronic traumatic spinal cord injury (SCI).

SETTING

An academic medical center in the Southeastern United States.

METHODS

4057 participants who were at least 18 years of age and 1 year post traumatic SCI with residual neurologic impairment were identified from three cohorts: a rehabilitation specialty hospital in the Southeastern USA and two SCI Surveillance System Registries, one in the Midwestern and one in the Southeastern USA. The participants completed a self-reported assessment on ED visits and ED hospitalizations (yes/no) in the past 12 months. Logistic regression models were used to examine the relationship between ED visits/hospitalizations and eight behavioral indicators, including body weight, healthy diet, drinking, smoking, non-medical substance usage, prescription medication usage, prescription medication misuse, and the planned exercise.

RESULTS

During the study period, 41% of participants reported having at least one ED visit and 21% participants reported hospitalization after ED visit in the past 12 months. High frequency of prescription medication usage, prescription medication misuse, and lack of planned exercise were associated with greater odds of at least one ED visit and at least one ED-related hospitalization, while smoking was only associated with ED visits.

CONCLUSIONS

Health care professionals should be aware that ED visit and related hospitalization prevalence remain high among people with chronic SCI, and there is significant need for intervention of managing risk behaviors and promoting healthy behaviors after SCI.

摘要

研究设计

横断面研究。

目的

确定人口统计学、损伤和行为因素与慢性创伤性脊髓损伤(SCI)患者急诊(ED)就诊和 ED 相关住院的相关性。

地点

美国东南部的一所学术医疗中心。

方法

从三个队列中确定了 4057 名至少 18 岁且创伤后 SCI 后 1 年仍存在神经功能损伤的患者:美国东南部的一家康复专科医院,以及两个 SCI 监测系统登记处,一个位于中西部,一个位于东南部。参与者完成了一项关于过去 12 个月内 ED 就诊和 ED 住院(是/否)的自我报告评估。使用逻辑回归模型来检查 ED 就诊/住院与八项行为指标(包括体重、健康饮食、饮酒、吸烟、非医疗物质使用、处方药使用、处方药滥用和计划锻炼)之间的关系。

结果

在研究期间,41%的参与者报告在过去 12 个月内至少有一次 ED 就诊,21%的参与者报告在 ED 就诊后住院。高频率的处方药使用、处方药滥用和缺乏计划锻炼与更高的 ED 就诊和至少一次 ED 相关住院的可能性相关,而吸烟仅与 ED 就诊相关。

结论

医疗保健专业人员应意识到,慢性 SCI 患者的 ED 就诊和相关住院率仍然很高,需要对管理风险行为和促进 SCI 后健康行为进行干预。

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