Medical complications and falls in patients with spinal cord injury during the immediate phase after completing a rehabilitation program

อาจารย์ ดร.จิราภรณ์ วรรณปะเข
Abstract Background/objectives:Complications and falls are crucial problems in patients with spinal cord injury (SCI). However, existing evidence on complications comes from data from hospital records over a long period of time, and falls were mostly reported retrospectively in patients with incomplete SCI. This study prospectively explored the occurrence of complications and falls, and associated factors in patients with SCI during the 6 months after discharge. Methods: One hundred subjects with SCI (50 wheelchair-bound (WB) and 50 ambulatory (AM) subjects) from a tertiary rehabilitation center completed the study. Every month, subjects were monitored for data on medical complications and falls. Descriptive information is provided for each group. Results: Every WB subject had complications and 14 subjects were re-hospitalized. The most frequent complications found in these subjects were neurogenic pain (36 subjects), urinary tract infection (UTI) (25 subjects), and pressure ulcers (21 subjects). In AM subjects, 38 subjects (76%) experienced complications and 3 subjects needed re-hospitalization. The most frequent complications included neurogenic pain (35 subjects) and UTI (11 subjects). Eighteen WB subjects (36%) and 27 AM subjects (54%) experienced falls. WB subjects had significantly increased odds for incidence of UTI and pressure ulcers, whereas AM subjects had significantly greater odds for falls (P < 0.05). Conclusion: A number of subjects with SCI experienced complications and falls after completing a rehabilitation program. The findings add to our knowledge about complications and falls after SCI, and confirm the importance of effective strategies to minimize the occurrence of complications and falls in these individuals. Keywords: Complication, Fall, Paraplegia, Rehabilitation, Tetraplegia