Zeinaddini-Meymand Arman, Baigi Vali, Mousavi-Nasab Mohammad Mehdi, Shool Sina, Sadeghi-Naini Mohsen, Azadmanjir Zahra, Jazayeri Seyed Behnam, Berchi Kankam Samuel, Dashtkoohi Mohammad, Shakeri Aidin, Fakharian Esmail, Kouchakinejad-Eramsadati Leila, Pirnejad Habibollah, Sadeghi-Bazargani Homayoun, Bagheri Laleh, Pourandish Yasaman, Amiri Malihe, Pour-Rashidi Ahmad, Harrop James, Rahimi-Movaghar Vafa
Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
Global Spine J. 2025 Mar;15(2):603-614. doi: 10.1177/21925682231202425. Epub 2023 Sep 21.
A retrospective study.
The quality of care (QoC) for spinal column/cord injury patients is a major health care concern. This study aimed to implement the QoC assessment tool (QoCAT) in the National Spinal Cord/Column Injury Registry of Iran (NSCIR-IR) to define the current state of pre- and post-hospital QoC of individuals with Traumatic Spinal Column and Spinal Cord Injuries (TSC/SCIs).
The QoCAT, previously developed by our team to measure the QoC in patients with TSC/SCIs, was implemented in the NSCIR-IR. The pre-hospital QoC was evaluated through a retrospective analysis of NSCIR-IR registry data. Telephone interviews and follow-ups of patients with SCI evaluated the QoC in the post-hospital phase.
In the pre-hospital phase, cervical collars and immobilization were implemented in 46.4% and 48.5% of the cases, respectively. Transport time from the scene to the hospital was documented as <1 hour and <8 hours in 33.4% and 93.9% of the patients, respectively. Post-hospital indicators in patients with SCI revealed a first-year mortality rate of 12.5% (20/160), a high incidence of secondary complications, reduced access to electrical wheelchairs (4.2%) and modified cars (7.7%), and low employment rate (21.4%).
These findings revealed a significant delay in transport time to the first care facilities, low use of immobilization equipment indicating low pre-hospital QoC. Further, the high incidence of secondary complications, low employment rate, and low access to electrical wheelchairs and modified cars indicate lower post-hospital QoC in patients with SCI. These findings imply the need for further planning to improve the QoC for patients with TSC/SCIs.
一项回顾性研究。
脊柱/脊髓损伤患者的护理质量是医疗保健的主要关注点。本研究旨在在伊朗国家脊髓/脊柱损伤登记处（NSCIR-IR）实施护理质量评估工具（QoCAT），以确定创伤性脊柱和脊髓损伤（TSC/SCI）患者院前和院后护理质量的现状。
我们团队之前开发的用于测量TSC/SCI患者护理质量的QoCAT在NSCIR-IR中实施。通过对NSCIR-IR登记数据的回顾性分析来评估院前护理质量。对SCI患者进行电话访谈和随访，以评估院后阶段的护理质量。
在院前阶段，分别有46.4%和48.5%的病例使用了颈托和固定装置。分别有33.4%和93.9%的患者记录的从现场到医院的转运时间<1小时和<8小时。SCI患者的院后指标显示，第一年死亡率为12.5%（20/160），继发性并发症发生率高，电动轮椅（4.2%）和改装汽车（7.7%）的使用率低，就业率低（21.4%）。
这些发现表明，到首个护理机构的转运时间存在显著延迟，固定设备使用不足表明院前护理质量较低。此外，继发性并发症发生率高、就业率低以及电动轮椅和改装汽车的使用率低表明SCI患者的院后护理质量较低。这些发现意味着需要进一步规划以改善TSC/SCI患者的护理质量。
