Causes and length of stay of readmission among individuals with traumatic spinal cord injury: a prospective observational cohort study

Spinal Cord, 2023 · DOI: https://doi.org/10.1038/s41393-023-00874-6 · Published: February 25, 2023

Spinal Cord Injury Healthcare Rehabilitation

Simple Explanation

This study looked at why people with spinal cord injuries (SCI) get readmitted to the hospital. Understanding these reasons can help prevent readmissions and improve healthcare services for SCI patients. The study found that urological problems, pressure injuries, and spasticity are the most common causes for readmission among individuals with traumatic SCI. The study also observed a trend where people from southern Italy travel to northern centers for specialized SCI treatment, suggesting a need for more attention to healthcare organization in certain geographic areas.

Study Duration

February 1st 2013 to October 31st 2015

Participants

1039 persons with traumatic SCI

Evidence Level

Prospective observational cohort study

Key Findings

1
Urological problems, pressure injuries, and spasticity are the most frequent causes of re-hospitalization in individuals with traumatic SCI.
2
Longer LoS was associated with pressure injury, rehabilitative needs, sexual, bowel, and pain problems.
3
People from the South of the country were frequently readmitted to the northern centers, suggesting geographic disparities in SCI-specific treatments.

Research Summary

This study aimed to explore the characteristics of individuals with SCI readmitted to the hospital, the reasons for readmissions, and the length of stay (LoS) for different conditions. The most frequent clinical complications were urological problems (60%), pressure injuries (40%), and spasticity (reported in one third of readmissions). Multivariate analysis on LoS showed that being classified in the three most serious neurological classifications (not D group), readmitted from facilities other than home, and readmitted in SCI centers located in regions other than the residency area was independently predictive of longer LoS.

Practical Implications

Preventive Strategies

Developing preventive strategies targeting frequent secondary complications in severe SCI cases can reduce readmissions.

Healthcare Resource Allocation

Addressing geographic disparities in SCI-specific treatments by improving healthcare networks in underserved regions.

Multidisciplinary Care

Providing comprehensive multidisciplinary care, including social support, to reduce LoS and improve outcomes.

Study Limitations

1
The study design did not allow to explore the entire burden of readmission of a prevalent population or a cohort of persons with SCI and it was not possible to compare results of this study to others SCI population-based studies.
2
A part of patients can be missed who were admitted to acute general medicine wards for complications and were not transferred to SCI centers.
3
There is a long time between data collection and manuscript submission due to the long period between the completion of data collection, their extraction and analysis, and the numerous group meetings for discussion of the results and consensus on the concept for the manuscript preparation.

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