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

journal contribution
posted on 2023-05-20, 10:12 authored by Teo, CP, Cheng, K, New, PW

Objective: Describe demographic characteristics, functional outcomes and disability following rehabilitation for non-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), and complications. 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-ischemic vascular SCDys were epidural hematoma (39%), dural arteriovenous fistula (17%), and arteriovenous malformation (11%). 22 cases (61%) were iatrogenic. Most (86%) had incomplete paraplegia. Urinary tract infection was the most common complication (64%). Median LOS in rehabilitation was 68 days. Significant improvement in FIM motor scores was observed from admission (median 25, interquartile range [IQR] 20–38) to discharge (median 69, IQR 38–77) (P < 0.001). On discharge, 4 patients (11%) walked >100 m unaided, 6 (17%) walked >100 m with assistive device, 10 (28%) walked >10 m with assistive device, 15 (41%) were wheelchair 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 to rehabilitation admission, but with the majority having ongoing major disabilities based on FIM motor scores.

History

Publication title

Journal of Spinal Cord Medicine

Pagination

1-6

ISSN

1079-0268

Department/School

Tasmanian School of Medicine

Publisher

Taylor & Francis

Place of publication

United States

Rights statement

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

Repository Status

  • Restricted

Socio-economic Objectives

Clinical health not elsewhere classified

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