¹Centre de Médecine Physique et de Réadaptation de la Tour de Gassies - 33523 Bruges, France

²Service de Médecine Physique et Réadaptation - Hôpital Pellegrin, Bordeaux, RFRH (Federative Network of Research on Disability) France

³INSERM (National Institute for Health and Medical Research), U502, CERMES-Paris, RFRH (Federative Network of Research on Disability) France

Correspondence to: R Klotz, Centre de Médicine Physique et de Réadaptation de la Tour de Gassies, Bruges 33523, France

^aSee Appendix

Study design: To study the short- and long-term medical complications encountered in tetraplegic spinal cord injured persons (TSCI) and to give prominence to both the medical and socio-economic factors with which they are respectively associated.

Methods: The Tetrafigap Study is a multicentre epidemiological survey carried out using self-administered questionniares studying the global long-term outcome of TSCI patients after the initial phase of rehabilitation.

Results: The data for 1668 patients were analyzed. The rate of rehospitalisations was 74.4% with on average three stays per patient and as reported causes, in descending order: urinary complications, systematic follow-up, pressure sores, respiratory complications, contractures, bowel complications, pains and secondary fractures of the lower limbs. At the time of the survey, 84.7% of patients mentioned awkward contractures, 73.8% pains, 55.9% embarrassing urinary leakage and 14.1% pressure sores. With regard to persons suffering from complete motor lesion, urinary complications and pressure sores were more frequently reported, whereas for persons suffering from incomplete motor lesions, awkward contractures and pains were more frequent. In the elderly, pains were more often mentioned, and pressure sores and pain were also the most common in patients coming from lower socio-professional status. Contractures and pain decreased with time. All these complications but pressure sores and pain are statistically interrelated.

Conclusion: The medical complications of spinal cord injured persons are frequent, they are linked to biological, psychological and environmental factors, and are interrelated. Therefore, seeking mid- and long-term risk factors must be given priority in order to better adapt attempts at increasing secondary prevention.

Spinal Cord (2002) 40, 457-467. doi:10.1038/sj.sc.3101317

tetraplegia; spinal cord injury; long-term outcome; complications; pressure sore; pain; urinary complications