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Observational Study
. 2023 Jul;61(7):383-390.
doi: 10.1038/s41393-023-00874-6. Epub 2023 Feb 25.

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

Marco Franceschini  1   2 , Lorenzo Cecconi  3 , Jacopo Bonavita  4 , Sanaz Pournajaf  5 , Salvatore Ferro  6 , Maria Cristina Pagliacci  7 ; Italian SCI Study Group
Collaborators, Affiliations
Observational Study

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

Marco Franceschini et al. Spinal Cord. 2023 Jul.

Abstract

Background: Secondary conditions may reduce function and participation in individuals with chronic Spinal Cord Injury (SCI). The knowledge of reasons for readmission to the hospital may be enlightening to prevent them and remodel the health services.

Study design: Multicenter prospective observational study of all consecutive readmissions of persons with SCI after rehabilitation completion.

Objectives: To explore the characteristics of individuals with SCI readmitted to the hospital, the reasons for readmissions and the burden on hospitalization in terms of length of stay (LoS) for different conditions.

Setting: 31 Italian specialized SCI centers.

Methods: Data on people with traumatic SCI readmitted to SCI centers were recorded about: age, sex, SCI level and severity group, geographical origin, readmission causes, clinical interventions during hospitalization, LoS and discharge destination. Linear and multiple logistic regression analyses were performed considering LoS (days) as dependent variable for correlations with independent variables. All tests were two-sided.

Results: Among 1039 persons with traumatic SCI enrolled (mean age 46, males 85%, tetraplegia 43%), 59.09% of the readmissions were caused by urological problems, 39.74% by pressure injury and 35.41% by spasticity (68% readmitted for ≥2 causes, associated with longer LoS). The mean LoS was 48 days: pressure injury, rehabilitative needs, sexual, bowel, and pain problems were associated with longer and urological problems with shorter LoS. People from the South of the country were frequently (68%) readmitted to the northern centers.

Conclusions: Urological problems, pressure injury and spasticity were the most frequent causes of re-hospitalization in individuals with traumatic SCI. The migration trend seeking SCI-specific treatments suggests geographic areas to which health care organizations need to pay more attention.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1. Italian regions and the number of centers participating in the study.
The red line indicates the subdivision of three geographical macroregions of Italy: Northern, Central, and Southern Italy.
Fig. 2
Fig. 2. Causes of readmission including clinical complications, and respective impact of interventions during the hospital stay.
The clinical conditions and the respective impact of interventions are shown in gray and black, respectively.
See this image and copyright information in PMC

References

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    1. Ferro S, Cecconi L, Bonavita J, Pagliacci MC, Biggeri A, Franceschini M, et al. Incidence of traumatic spinal cord injury in Italy during 2013-2014: a population-based study. Spinal Cord. 2017;55:1103–7. doi: 10.1038/sc.2017.88. - DOI - PubMed
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