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Retrospective study of functional outcomes and disability after non-ischaemic vascular causes of spinal cord dysfunction

Teo, CP, Cheng, K and New, PW 2019 , 'Retrospective study of functional outcomes and disability after non-ischaemic vascular causes of spinal cord dysfunction' , Journal of Spinal Cord Medicine , pp. 1-6 , doi: 10.1080/10790268.2019.1645405.

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Abstract

Objective: Describe demographic characteristics, functional outcomes and disability following rehabilitation fornon-ischemic vascular spinal cord dysfunction (SCDys).Design: Retrospective, open cohort, case series.Setting: Tertiary rehabilitation unit, Victoria, Australia.Participants: Patients with non-ischemic vascular SCDys admitted over a 21-year-period (01/01/1995–31/12/2015) were identified using International Classification of Diseases codes.Outcome Measures: Demographic characteristics, etiology, neurologic classification, length of stay (LOS), andcomplications. On admission and discharge, the following were collected: functional independence measure(FIM) motor subscale, details on bowel, bladder, mobility, living arrangement, and support services.Results: 36 patients (female 58%; mean age 69 ± 16 years) were identified. The main causes of non-ischemicvascular SCDys were epidural hematoma (39%), dural arteriovenous fistula (17%), and arteriovenousmalformation (11%). 22 cases (61%) were iatrogenic. Most (86%) had incomplete paraplegia. Urinary tractinfection was the most common complication (64%). Median LOS in rehabilitation was 68 days. Significantimprovement in FIM motor scores was observed from admission (median 25, interquartile range [IQR] 20–38)to discharge (median 69, IQR 38–77) (P 100 m unaided,6 (17%) walked >100 m with assistive device, 10 (28%) walked >10 m with assistive device, 15 (41%) werewheelchair dependent and 1 (3%) patient remained non-mobile. 20 patients (56%) were discharged home, 8(22%) to nursing home, and 8 (22%) transferred to another hospital.Conclusion: Most patients returned home with significantly improved functional outcomes compared torehabilitation admission, but with the majority having ongoing major disabilities based on FIM motor scores.

Item Type: Article
Authors/Creators:Teo, CP and Cheng, K and New, PW
Keywords: epidemiology, recovery of runction, rehabilitation, spinal cord injuries, spinal cord vascular diseases
Journal or Publication Title: Journal of Spinal Cord Medicine
Publisher: Taylor & Francis
ISSN: 1079-0268
DOI / ID Number: 10.1080/10790268.2019.1645405
Copyright Information:

Copyright 2019 The Academy of Spinal Cord Injury Professionals, Inc.

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