Causes and length of stay of readmission among individuals with traumatic spinal cord injury: a prospective observational cohort study
Marco Franceschini, Lorenzo Cecconi, Jacopo Bonavita, Sanaz Pournajaf, Salvatore Ferro, Maria Cristina Pagliacci, the Italian SCI Study Group, Salvatore Ferro, Maria donate Bellentani, Marco Franceschini, Augusto Cavina, Jacopo Bonavita, Maria Cristina Pagliacci, Annibale Biggeri, Lorenzo Cecconi, Federico De Iure, Giovanni Gordini, Tiziana Redaelli, M. V. Actis, Giulio Del Popolo, Giannettore Bertagnoni, Renato Avesani, Vincenzo Falabella, M. V. Actis, M. Stillittano, Salvatore Petrozzino, Carlo Cisari, Marco Salvini, Tiziana Redaelli, R. Tosi, Carolina Borghi, Amarjeet Bava, Caterina Pistarini, Guido Molinero, Antonio Signorelli, S Sandri, F. Simeoni, M. Brambilla, M. A. Banchero, A. Olivero, G. Zanaboni, Renato Avesani, Giannettore Bertagnoni, M. Leucci, Lisa Lain, Mario Saïa, Agostino Zampa, P. Del Fabro, Marsilio Saccavini, A. Fanzutto, Antonino Massone, Jacopo Bonavita, D. Gaddoni, Silvia Olivi, Giuseppe Musumeci, Roberto Pederzini, Humberto Cerrel-Bazo, Daniele Giovanni Nicolotti, M. Nora, Rodolfo Brianti, Corrado Iaccarino, Annalisa Volpi, Adolph V. Lombardi, S. Cavazza, Federica Casoni, Federico De Iure, Giovanni Gordini, Roberto Piperno, G. Teodorani, Andrea Naldi, G. Vergoni, Elisa Maietti, A. Botti, Salvatore Ferro, G. Pagoto, Giulio Del Popolo, Mark Moresi, M Postiglione, Chiara Bini, Mary Tagliaferri, M. A. Recchioni, P Pelaia, Lucia Di Furia, Maria Cristina Pagliacci, Renée Maschke, Luigi Caruso, L. Speziali, M. Zenzeri, Pietro Fiore, Riccardo Marvulli, R Nardulli, Crocifissa Lanzillotti, Maria Ruccia, Maria Pia Onesta, Tiziana Di Gregorio, F. Franchina, M. G. Furnari, Claudio Pilati, Marco Merafina, F. Crescia
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.