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Medical conditions and outcomes at 1 year after acute traumatic spinal cord injury in a Greek and a Swedish region : a prospective, population-based study

journal contribution
posted on 06.12.2017, 00:00 by Anestis DivanoglouAnestis Divanoglou, N Westgren, S Bjelak, R Levi
Study design: Prospective, population-based study. This paper is part of the Stockholm Thessaloniki Acute Traumatic Spinal Cord Injury Study (STATSCIS). Objectives: To evaluate and compare outcomes, length of stay (LOS), associated conditions and medical complications at 1-year post-trauma. Settings: The Greater Thessaloniki region, Greece, and the Greater Stockholm region, Sweden. While Stockholm follows a SCI system of care, Thessaloniki follows a fragmented ‘non-system’ approach. Subjects: Out of the 87 cases in Thessaloniki and the 49 cases in Stockholm who comprised the study population of STATSCIS, 75 and 42 cases respectively were successfully followed-up during the first year post-trauma. Results: Significantly superior outcomes (that is, survival with neurological recovery, functional ability and discharge to home) and shorter LOS for initially motor complete cases occurred in Stockholm. Management routines known to increase long-term morbidity, for example, long-term tracheostomy and indwelling urethral catheters were significantly more common in Thessaloniki. Major medical complications, that is, multiple pressure ulcers, heterotopic ossification and bacteremia/sepsis were more frequent in Thessaloniki. Conclusions: Our findings show how two rather similar cohorts of TSCI manifest large discrepancies in terms of 1-year outcomes and complications, depending on the type of management they receive. As the major difference between regions was the presence or absence of a SCI system of care, rather than differences in availability of modern medicine, the mere presence of the latter does not seem to be sufficient to guarantee adequate outcomes. This study provides strong evidence as to the urgent need of implementing a SCI system of care in Greece.

Funding

Category 1 - Australian Competitive Grants (this includes ARC, NHMRC)

History

Volume

48

Start Page

470

End Page

476

Number of Pages

7

eISSN

1476-5624

ISSN

1362-4393

Location

United Kingdom

Publisher

Nature Publishing Group

Language

en-aus

Peer Reviewed

Yes

Open Access

No

External Author Affiliations

Karolinska Universitetssjukhuset; Karolinska institutet; Rehab Station Stockholm; TBA Research Institute; Umeå universitet;

Era Eligible

Yes

Journal

Spinal cord.