Swiss Paraplegic Centre, Nottwil, Switzerland.
Swiss Paraplegic Research, Nottwil, Switzerland.
Spinal Cord. 2023 May;61(5):290-295. doi: 10.1038/s41393-023-00880-8. Epub 2023 Feb 13.
Population-based prospective study.
To provide a population-based description of length of stay (LOS) and person-related risk factors following unplanned hospital admission due to a secondary health condition (SHC) in persons with spinal cord injury (SCI).
Specialized SCI hospital and rehabilitation center in Switzerland.
Descriptive analysis of LOS using routine clinical data of persons with SCI, who were acutely hospitalized between 01.01.2017-30.06.2018. Multivariable regression analysis was used to derive marginal predictions of LOS by acute SHCs and person characteristics.
The study included 183 persons, 83% were male, and the median age was 57 years (interquartile range, IQR, 49-67 years). SCI cause was traumatic in 160 (88.4%) cases, 92 (50.3%) were persons with tetraplegia, 147 (80.3%) were classified as motor complete lesions (American Spinal Injury Association Impairment Scale (AIS) A or B) and median time since injury (TSI) was 24 (IQR 13-34) years. Median LOS was 19 (IQR 9-39) days, varying from 74 (IQR 39-92) days for pressure ulcers, 13 (IQR 8-24) days for urinary tract infections (UTI), to 27 (IQR 18-47) days for fractures. LOS was prolonged in persons with multiple co-morbidities or those developing complications during hospitalization. Sex, SCI etiology and lesion level were not associated with LOS.
This population-based description identified substantial variation in LOS between acute SHCs and clinical complications as the main, potentially modifiable, person-related risk factors for extended hospital stay.
基于人群的前瞻性研究。
为因继发健康状况（SHC）而意外住院的脊髓损伤（SCI）患者提供有关住院时间（LOS）和与患者相关的风险因素的基于人群的描述。
瑞士专门的 SCI 医院和康复中心。
对 2017 年 1 月 1 日至 2018 年 6 月 30 日期间因急性 SHC 住院的 SCI 患者的常规临床数据进行 LOS 的描述性分析。使用多元回归分析得出急性 SHC 和患者特征对 LOS 的边际预测。
该研究纳入了 183 名患者，其中 83%为男性，中位年龄为 57 岁（四分位距，IQR，49-67 岁）。SCI 病因在 160 例（88.4%）为创伤性，92 例（50.3%）为四肢瘫痪患者，147 例（80.3%）为运动完全损伤（美国脊髓损伤协会损伤分级（AIS）A 或 B），损伤后时间（TSI）中位数为 24 年（IQR 13-34 年）。中位 LOS 为 19 天（IQR 9-39 天），从压疮的 74 天（IQR 39-92 天）、尿路感染（UTI）的 13 天（IQR 8-24 天）到骨折的 27 天（IQR 18-47 天）不等。合并多种合并症或在住院期间发生并发症的患者 LOS 延长。性别、SCI 病因和损伤水平与 LOS 无关。
本基于人群的描述确定了急性 SHC 和临床并发症之间的 LOS 存在显著差异，这是导致住院时间延长的主要（潜在可改变的）与患者相关的风险因素。
