Strengthening Health Systems for Persons With Traumatic Spinal Cord Injury in South Africa and Sweden: A Protocol for a Longitudinal Study of Processes and Outcomes

Frontiers in Neurology, 2018 · DOI: 10.3389/fneur.2018.00453 · Published: June 14, 2018

Simple Explanation

This study explores healthcare processes and outcomes for traumatic spinal cord injury (TSCI) patients in South Africa and Sweden. It aims to describe acute care processes, determine short- and long-term outcomes, and identify predictors for survival and functioning. The research involves a prospective cohort study, recruiting adults with acute TSCI in Cape Town and Stockholm over at least a year. Data will be collected on admission, discharge, and 12 months post-injury. By comparing care processes and outcomes in South Africa and Sweden, the study aims to strengthen management guidelines for TSCI care, especially in South Africa, where specialized care is less accessible.

Study Duration

At least 1 year

Participants

Anticipated 200 adults with acute TSCI

Evidence Level

Not specified

Key Findings

1
The study hypothesizes that processes of care will better align with international guidelines in Sweden compared to South Africa.
2
Researchers expect worse acute and long-term outcomes for TSCI survivors in South Africa due to differences in healthcare systems.
3
The study aims to identify factors influencing mortality and functioning after TSCI, which can inform clinical decision-making and improve patient care.

Research Summary

This study investigates health care processes and outcomes of traumatic spinal cord injury (TSCI) care in South Africa and Sweden to strengthen management guidelines for SCI. The study will describe acute processes of TSCI care, determine acute- and long-term outcomes of TSCI care, and identify predictors for survival, secondary complications, and functioning 12 months post-injury. A prospective, regional population-based cohort study will recruit adults with acute TSCI over at least a 1-year period from Cape Town and Stockholm, collecting data at admission, discharge, and 12 months post-injury.

Practical Implications

Improved Clinical Guidelines

The study's findings can inform and strengthen clinical practice guidelines for TSCI care, particularly in South Africa, where specialized care is less accessible.

Informed Policy Decisions

The research can provide hospital management and policymakers with evidence to assess the feasibility and cost-effectiveness of changes in processes/interventions.

Targeted Interventions

The development of a clinical decision-making model can assist in identifying individuals most at risk and ensuring they receive timely and appropriate care.

Study Limitations

1
The study relies on data from specific regions in South Africa and Sweden, which may limit generalizability.
2
Loss to follow-up may affect the statistical power and validity of the results.
3
The observational design may not establish causality between processes of care and outcomes.

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