Hospital care of postacute spinal cord lesion patients in Italy: analysis of readmissions into the GISEM study

Abstract

Objectives: To define the clinical characteristics of hospital readmissions of subjects with spinal cord lesion.

Design: Prospective, multicenter, 2-yr survey in 32 spinal cord lesion centers in Italy. Readmitted traumatic or nontraumatic spinal cord lesion patients were included. Main outcome measures were number of readmissions, their causes, complications on admission, and length of stay.

Results: Out of 2070 total admissions of patients with spinal cord lesion, 1056 (51.0%) were readmissions. The median period between the onset of disease and readmission was 3.4 yrs. A program of functional gain was the main cause of readmission (33%). A pressure sore was reported in 20.6% of cases on readmission. Readmission for a program of functional gain was correlated to nontraumatic and incomplete lesions. Readmission necessary for clinical complications was correlated to traumatic spinal cord lesion and completeness of the lesion. A longer length of stay correlated with cause of readmission, admission to rehabilitation centers, and nontraumatic origin.

Conclusions: Readmissions account for more than half of total admissions to centers for spinal cord lesion in Italy. The main burden is represented by a program of functional gain, pressure sores, and urological complications.