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脊髓损伤患者在初次康复后 10 年内再住院的流行率、原因和风险特征。

Prevalence, causes, and risk profile of rehospitalizations in persons with spinal cord injury within the first 10 years after primary rehabilitation.

机构信息

Swiss Paraplegic Centre, Nottwil, Switzerland.

Swiss Paraplegic Research, Nottwil, Switzerland.

出版信息

Spinal Cord. 2024 Nov;62(11):625-633. doi: 10.1038/s41393-024-01028-y. Epub 2024 Sep 5.

Abstract

STUDY DESIGN

Retrospective cohort study.

OBJECTIVES

This study aims to identify the prevalence, causes, time pattern and risk profile of rehospitalizations in persons with spinal cord injury (SCI) within a 10-year period following primary rehabilitation and identify most common secondary health conditions (SHCs) and risk profile leading to rehospitalizations.

SETTING

Specialized hospital and rehabilitation center for SCI in Switzerland.

METHODS

A retrospective analysis was conducted on clinical data from persons with SCI, discharged from initial rehabilitation between January 1, 2010, and December 31, 2012, and followed up over a period of ten years post-discharge. Descriptive statistical methods were utilized to compute the rehospitalization prevalence and to identify the primary reasons.

RESULTS

225 participants were included, 70% were male (n = 179), and the mean age was 50 years (SD 19, Range 17-88). 54% were classified as having paraplegia (n = 122), and 77% incomplete injuries (n = 180). Over the 10-year observation period post-discharge, 120 were readmitted at least once, (prevalence 53%). In total, 66 persons (29%) were rehospitalized once or twice, while 54 persons (24%) were rehospitalized three or more times, with a maximum of 14 times. In the 10-year period, the most common SHCs leading to rehospitalization were infections (19%), pressure injuries (18%), and gastrointestinal problems (16%). During the study period, 57 persons (25%) passed away.

CONCLUSIONS

Rehospitalization after primary rehabilitation is frequent and in the majority of the cases due to SHCs. The study findings are valuable for resource planning in healthcare and can guide the implementation of preventive measures to avoid SHCs.

摘要

研究设计

回顾性队列研究。

目的

本研究旨在确定在初次康复后 10 年内,脊髓损伤(SCI)患者的再入院率、原因、时间模式和风险特征,并确定导致再入院的最常见的次要健康状况(SHC)和风险特征。

设置

瑞士 SCI 专科医院和康复中心。

方法

对 2010 年 1 月 1 日至 2012 年 12 月 31 日期间出院的 SCI 患者的临床数据进行回顾性分析,并在出院后进行了长达 10 年的随访。采用描述性统计方法计算再入院率,并确定主要原因。

结果

共纳入 225 名参与者,其中 70%为男性(n=179),平均年龄为 50 岁(SD 19,范围 17-88)。54%为截瘫(n=122),77%为不完全损伤(n=180)。在出院后的 10 年观察期内,有 120 人至少入院一次(患病率为 53%)。总共有 66 人(29%)入院一次或两次,54 人(24%)入院三次或更多次,最多入院 14 次。在 10 年期间,导致再入院的最常见 SHC 是感染(19%)、压疮(18%)和胃肠道问题(16%)。在研究期间,有 57 人(25%)死亡。

结论

初次康复后再入院的情况较为频繁,大多数是由于 SHC。研究结果对医疗保健资源规划具有重要价值,并可指导实施预防措施,避免 SHC。

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